Ted Reed recently retired from twenty years of teaching math at Elkhorn Community College. In retirement, he has remained so active that his friends joke that he has “flunked retirement.” Ted reads avidly, has resumed playing the piano, volunteers, and travels around the country attending Elderhostel programs.
Over the past year, Ted has also spent a fair amount of time with his good friend, Jim, who was diagnosed with cancer. Ted watched him undergo chemotherapy and multiple hospitalizations, and eventually lose his battle to cancer, a mere shadow of his former self.
Jim’s death caused Ted to wonder what would happen to him if he were diagnosed with a terminal illness. He wouldn’t want to have his life prolonged if he were no longer able to engage in those activities that gave his life purpose. To avoid a prolonged and difficult dying that Jim experienced, he decided to complete a living will and a durable power of attorney for health care. Ted was unmarried but had two sisters and a younger brother. Ted named his brother as his proxy decision maker.
One morning, Ted began to experience severe chest pain. He was taken to the ED of the local hospital, where he was diagnosed as having suffered a severe heart attack. His physicians, in fact, are surprised that he even survived. After a week of hospitalization, Ted was sent to Mount Mary Home for further recuperation.
After three weeks at the home, Ted developed pneumonia. Ted’s physician believes that Ted should be transferred to the hospital and placed on a ventilator to assist his breathing until antibiotics could clear up the pneumonia. Medications for his heart condition as well as the pneumonia have left Ted disoriented. His physician does not believe that he has the capacity to make decisions about his care. The physician contacts Ted’s brother to authorize the hospitalization and treatment.
Ted’s brother produces the advance directive and says that nothing should be done for Ted’s pneumonia. “Ted would never want to live like this,” his brother states, “where he can no longer do anything that he used to enjoy.”
Ted’s physician disagrees with the brother. He disapproves of advance directives and does not believe that Ted is terminal. Ted can recover from this bout of pneumonia, though his heart problems will leave him with a very restricted life style. But he is not terminal. Ted’s two sisters also disagree with Ted’s brother. They believe everything should be done to save Ted’s life.
The chaplain at the Home is approached by the facility’s administrator about mediating the dispute. While she has encountered similar disputes in the past, this is the first time she has encountered a conflict where the patient’s life is at stake. She herself wonders who is right. (This case has been adapted with permission from Janine Idziak, Ethical Dilemmas in Long Term Care, Dubuque: Simon & Kolz Publishing, second edition, 2002, pp. 115-117).