09-06-2011, 04:43 PM
A 64-year-old woman with Multiple Sclerosis is hospitalized. The team feels she may need to be placed on a feeding tube soon to assure adequate nourishment. They ask the patient about this in the morning and she agrees. However, in the evening (before the tube has been placed), the patient becomes disoriented and seems confused about her decision to have the feeding tube placed. She tells the team she doesn't want it in. They revisit the question in the morning, when the patient is again lucid. Unable to recall her state of mind from the previous evening, the patient again agrees to the procedure.
Is this patient competent to decide?
a.This patient is competent to decide because her underlying disease is NOT impairing her decision making capacity.
b.This patient is competent to decide during her lucid periods.
c.The patient’s decision making capacity is questionable, and getting a surrogate decision maker involved can help determine what her real wishes are.
d.In this situation where the patient is changing her decision, the doctor should decide whether or not to place a feeding tube.
Is this patient competent to decide?
a.This patient is competent to decide because her underlying disease is NOT impairing her decision making capacity.
b.This patient is competent to decide during her lucid periods.
c.The patient’s decision making capacity is questionable, and getting a surrogate decision maker involved can help determine what her real wishes are.
d.In this situation where the patient is changing her decision, the doctor should decide whether or not to place a feeding tube.