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Due to Changed Mental Condition, a 67-Year-Old Man Is Sent

Question 11

Multiple Choice

Due to changed mental condition, a 67-year-old man is sent to the emergency room via ambulance. He was eating supper with his daughter when he grew disoriented and collapsed over. The patient has a history of atrial fibrillation and is taking an anticoagulant. He is a widower living with his daughter. The blood pressure is 208/113 mm Hg, the pulse is 64 beats per minute and irregular, and the respirations are 15/minute. On room air, oxygen saturation is 88 percent. The patient is dazed and unable to respond to directions. Pupils are medium in size and do not react to light. The physician concludes that intubation is required at this time to preserve the patient's airway and obtains approval from the patient's daughter and elder son who are present at the bedside. They tell the physician that the patient does not have an advance directive and they are unsure how to proceed.  Which of the following is the most appropriate next step in decision-making for this patient?


A) Ask the daughter to make a decision based on what she thinks is the best for the patient because he lives with her
B) Ask the son to make a decision based on what he thinks is the best for the patient because he is older and has legal authority
C) Ask them both to make a decision based on what they think is in the best interest of the patient
D) Ask them both to make a decision based on what they think the patient would have wanted if he was able to make the decision
E) Offer to make the decision on the patient's behalf based on the physician's best medical judgment

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