title: Discussing goals of care for a delirious advanced cancer patient in the hospice setting.
abstract: In the United States, patient autonomy is generally considered the most important ethical principle; however, patients sometimes make decisions that are medically futile or in conflict with the principles of beneficence and nonmaleficence. Difficult issues are often compounded if the patient loses capacity and a surrogate must provide substituted judgments. Allowing autonomy free reign can sometimes be detrimental to patient care and contribute to family distress. Here, we describe the case of a terminally ill patient whose conflicting desires were to have "everything" done--including cardiopulmonary resuscitation--and to simultaneously avoid hospitalization and die peacefully at home.
authors: 1 Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center , Houston, Texas.
authors: Caroline
authors: C
authors: Ha
authors: Akhila
authors: A
authors: Reddy
authors: Linda
authors: L
authors: Tavel
authors: Eduardo
authors: E
authors: Bruera
mesh_terms: D016223:Advance Directives; D003693:Delirium; D005260:Female; D017051:Hospice Care; D006801:Humans; D007414:Intestinal Neoplasms / Q000628:therapy*; D008875:Middle Aged; D010166:Palliative Care; D010817:Physician-Patient Relations
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