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Determining Patient Capacity for Making Medical Decisions

Mrs. Camel is a 45 year-old woman admitted to the hospital with pneumonia and a large mediastinal mass, diagnosed as inoperable lung cancer. She is a heavy smoker and drinker and experienced a 20 pound weight loss and progressive weakness over the last 6 months. Palliative radiation therapy is recommended to prevent post-obstructive pneumonia and to improve breathing. A stomach feeding tube (PEG) is recommended because swallowing difficulties may arise from radiation treatments. Mrs. Camel denies that she has cancer and refuses further workup and treatment. She is confused and agitated and has to be restrained at times. Her confusion and agitation may be dementia or delirium related to alcohol abuse or brain metastases. During a lucid period, she appoints her husband of 20 years as her healthcare proxy...

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Published: Friday, April 2, 2004
Filed Under: Case Study, Principles of Bioethics
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