Central Line Dissent and Fatal Dialysis Fear: The Story of Florence

Abstract

This case study focuses on an incapable patient requiring life-saving medical intervention to which she does not assent and the ethical challenges that stem from this refusal. This article discusses the law’s limitations in managing such situations as well as the difficulties for substitute decision makers (SDMs) and the clinical team when SDMs consent to treatment that cannot proceed without patient cooperation. The moral distress that befalls the clinical team and caregivers in these unique situations lead one to conclude that resources should be made available to support families who are suffering when loved ones deny needed therapies. From an ethics point of view, one can conclude that organizational support should be available to clinical teams to effectively manage these challenging cases.