End-of-life issues: Case I

Consulting the family of an incompetent patient is necessary in order to en sure that you take into account (a) any information that is known about wha t the patient would have wanted; (b) any signs as to what the patient wants now; (c) the capacity of the family and/or nursing home to look after the patient; and (d) the views of the family and primary caregivers on the appr opriateness of various forms of treatment and care. Futile or overly burdensome treatment should not be administered. Social prejudices against elderly and/or demented people may unjustly deny them appropriate medical and nursing care. The ethical challenges facing families/caregivers of incompetent patients s hould be framed in ways that genuinely help them to come to reasonable solu tions.