Matters of the Heart
A young woman in her 20s comes in with an infected heart. Her infection and heart failure are pretty much past the point of recovery. Her only option was IV antibiotics, hope they work, and plan for hospice care.
Her IV lowered the infection but the heart and valve damage were extensive. It was so extreme that the heart was producing micro-clots.
After the micro-clots, her fingertips went purple and clots migrated to her lungs. When she arrived in my ICU ward she was struggling to breathe. At this point, she decides to fill out a DNR or Do Not Resuscitate and move into hospice care.
Unfortunately, our state has a loophole where if the patient becomes unresponsive their proxy can change the DNR. Sadly, the worst happened.
Her mom went to court and was granted healthcare proxy rights. This meant once the daughter was disoriented, her medical decisions belonged to her mother.
The first thing her mom did was cancel the DNR, and our team was forced to put her on life support. This lasted for months and her arms and legs became purple, black, green, then necrotic.
Her organs were failing and the clots had traveled to her brain. She was unresponsive and we knew it shouldn’t be prolonged. We took the case to risk management, we held ethics meetings, and we went to court against the mother to revoke her healthcare proxy to fight for the patient’s right to die with dignity.
The court refused and mom stayed in control. _AVA_