An 85-year-old female with metastatic colon cancer is admitted to a long-term care facility due to
functional decline. She is cognitively intact and has decision-making capacity. Her family, which includes
her husband of 50 years, and 2 daughters, is very loving and devoted to her.
She has an automatic implantable cardiac defibrillator (AICD) for ventricular arrhythmias. Upon
admission, she requests the nurse practitioner to contact her cardiologist to turn off the AICD. The
nursing staff, as well as the administrator, are not comfortable with this request. They feel that the
patient is trying to find ways to speed up her death, and if the facility complies with her request, they
can be held liable.
Answer these questions:
1. Is it appropriate for her to make this request to withdraw this medical intervention? Why or why not?
2. What factors and/or legal documents support or negate the patients rights to make this request? Consider the Patient Bill of Rights, and others.
3. If the facility doesnt comply with her request, are her rights being violated? If so, which ethical
principle(s) is being violated?
4. What is the NPs role in this dilemma? What can he/she do to bring about a resolution?
