title: Clinical ethics case report: questionable capacity and the guidance of living wills.
abstract: After falling from a roof, an older man lost neurological function below his face. In two days, the patient regained consciousness, but it was unclear whether he could communicate his preferences, whether due to injuries or difficulties with language. His family believed he could communicate with them, and that he was capable of making treatment decisions. The staff did not think to contact the hospital's largely inactive ethics consultation service for assistance, and instead looked to the patient's living will for guidance, even though the patient was not terminally ill, and his lack of capacity had not been determined.
authors.affiliation: Department of Hematology and Medical Oncology, City of Hope National Medical Center, Duarte, California, USA. arivanderw@gmail.com
authors.forename: Ari
authors.initials: A
authors.lastname: VanderWalde
mesh_terms: D000058:Accidental Falls; D024362:Advance Directive Adherence / Q000941:ethics*; D000368:Aged; D002574:Cervical Vertebrae / Q000293:injuries; D003144:Communication Barriers; D003657:Decision Making; D033061:Ethics Consultation / Q000941:ethics / Q000592:standards; D004992:Ethics, Medical; D004993:Ethics, Nursing; D006801:Humans; D007558:Italy; D007802:Language; D016224:Living Wills; D008297:Male; D016743:Mental Competency; D026684:Personal Autonomy; D016414:Resuscitation Orders / Q000941:ethics; D016103:Spinal Fractures / Q000150:complications / Q000209:etiology; D014177:Translations; D028761:Withholding Treatment / Q000941:ethics*