title: The Enduring Case.
abstract: In clinical ethics an enduring case takes on a life of its own and comes to closure over a long period of time. This essay describes the evolution of such a case over a 1-year period. The case involves a 90-year old male patient with multiple chronic medical conditions who lacked decision-making capacity, was a resident of a long-term care facility, and did not have known previously expressed wishes regarding medical treatment. The ethics consultation initially revolved around this question: What method or process must be employed so that medical treatment decisions could be ethically reviewed and could include a shared decision-making process for Mr. Smith? This case analysis describes the evolution of this case and argues that the good of the patient must remain paramount throughout an enduring case.
authors: Craig M
authors: CM
authors: Nelson
mesh_terms: D016223:Advance Directives; D000369:Aged, 80 and over; D003657:Decision Making / Q000941:ethics*; D033061:Ethics Consultation; D026690:Ethics, Clinical; D006801:Humans; D008134:Long-Term Care; D008297:Male; D016743:Mental Competency; D010358:Patient Participation