Social Sciences Main社会医学 1-10.pptx

Social Sciences Main1-10Q 1A 68-year-old mart is brought to the hospital due to 2 days of progressive shortness of breath and cough. He has a history of severe chronic obstructive pulmonary disease and has had multiple recent exacerbations and several hospitalizations over the past year. During his last hospitalization, he had acute respiratoryfailure requiring endotracheal intubation. This prompted the patient to make a living will specifying that he does not want any resuscitative measures or invasive therapies in the event of a life-threatening emergency. On examination, he is lethargic and arousabie only to noxious physical stimuli. His temperature is 37.2℃ (99℉)t blood pressure is 132/70 mm Hg， pulse is 102/min, and respirations are 32/min. Examination reveals diffusely decreased breath sounds, bilateral expiratory wheezes, and labored breathing. It is determined that he lacks decision-making capacity. His daughter says,I have been taking care of my father for many years and I know him better than anyone. He would not want any aggressive measures. Please just make him comfortable. However, the patients wife demands that everything be done to save her husbands life, including intubation if necessary. She insists that she knows what her husband would have wanted and threatens to file a lawsuit. Which of the following interventions is the most appropriate next step?A.Consult the hospital ethics committeeB.Meet with all family members to achieve consensus on a course of action C. Obtain a court order to proceed with intubationD.Proceed with endotracheal intubation if medically indicatedE.Respect the patients living will and provide comfort care onlyA 1 Correct answer: EA living will (advanced directive) specifies a patients wishes for health care in advance of losing the ability to communicate or of becoming incapable of making his or her own decisions. In this case, the patient is incapacitated and his family members strongly disagree on the best course of action;