Case Study – Nonadherence to Care?

Case Study - Nonadherence to Care?

A patient in a hospital bed.By Ryan Pferdehirt, D.Bioethics, HEC-C

December 2019






Patient is a 30-year-old female, presenting with multiple co-morbidities including HIV, COPD and cardiac complications. After several weeks in the ICU, the patient’s condition continued to not improve. Due to, in all likelihood, the patient’s nonadherence to medical care over the years and “reckless behavior,” there is little expectation for a full recovery. The attending physician was heard saying, “I’ve seen this patient a million times. Another one who does not care about herself. Why should we have to care about her? Care more about her than she cares for herself.” The physicians then put in a recommendation to not place a trach and peg and change code status to “comfort measures only.” The nursing staff are concerned that the physician is “not giving this patient a chance.” An ethics consult was requested.