Husband refuses life-saving treatment for his wife | Chicago Med 

Risks of the trade as a hospital shrink. I bet he's used to it. Still though, everyone has the right to a second opinion, and the thought that the daughter couldn't request it is bonkers

I wonder how much experience he has in controlling coercive family violence. I note he was dismissive of the wife’s suspicions of the husband. Yet often these are very real, and not paranoia. I get that someone would not want treatment in the end stages of Alzheimers, but not when they have a reasonable degree of autonomy. I would be questioning why the advanced directive was so comprehensive for the early stages. I know the writers would not have been intending this scenario, but in real life this situation would be raising a lot of red flags for me of family violence.

nobody is an “expert” at anything if you really look at things. they just learn what has already been discovered

@@auds3551 Thanks for that profound deepthink Socrates

😊😊😊

Kkm

More the patient’s choice first. If determine to not have the cognitive need, then the family or the substitute decision marker.

On one hand, safe the patient's life, on the other, they had a script they must follow to shoot the episode.... Yeah, I'll see myself out....

@@ilanavonronge7166 ! נ

@@ilanavonronge7166 ! נ

Yes I believe sometimes the way patients are assessed to see if they are mentally capable to make a decision it can be actually kind of ableist and take agency away from the patient. She's still a person and if she's able to express desires and they make logical sense and they can't come with harm then they should be respected

The problem with this is that people with Alzheimer's also don't have the full capacity to understand what they are deciding on, as Dr. Charles has pointed out. Like he said when they were in the meeting with Goodwin, it is a deteriorating disease that degenerates and destroys a person. People can have moments of lucidity, and they CAN make that decision, but that lucidity doesn't stay for long.. especially as the disease progresses. That is why the AD was done to avoid situations like this.

I totally agree, my grandfather has alzheimers and we let him make the decisions for as long as he could vocalise them except for his decision to not be in a nursing home, we had to put him in because it was getting far too dangerous for him in a 3 story home. My family is not one to resist medical intervention so I doubt we’d ever make a list like this, but if we did, if he changed his mind at any point about one of the procedures we wouldn’t fight him on it, because watching someone die terrified when a procedure they said they didn’t want years ago is the only way of saving them is terrible, just let them have the procedure.

I am a dementia specialist nurse working in the UK and quite often I'm asked if someone 'has capacity' or not. It is not as black and white as you would believe. Each person's circumstances need to be considered fully before any decision made is rubber stamped. I've seen too many incidents of people voicing what they think should happen to someone regardless of what the person concerned actually wants. There are no easy answers in those situations.

Agreed

My granddad had similar views. He had all the right paperwork. Then he got very sick. Luckely he passed away on his own prior to us family having to fully start the fight to forfill his wish. As sad as we were that he passed, he did so according to his own terms.

I watched my grandma go down this same path. I've decided no mater what I say at the time, if my mental capacity is technically impacted, I'm DNR, as long as I'm mentally competent I want to stay alive.

If i knew i have Alzheimer's, im gonna do so much coke and weed in one go so i will exit the World like a King! If all else fails, i have a gun ready

@@ShadowMoon878 Why would you do that?

@@mikaelarutyunov9578 Read the original comment and you understand (maybe). But I’ll try to explain it from my view. It’s a horrible feeling to see you are losing yourself to a disease and know that at one point you are going to be nothing more than a empty shell of yourself. Not being capable of doing anything, losing the memories, the focus, everything. Not recognizing people you love… it’s natural to fear that. So - obviously many would like to avoid that destiny - even by choosing the death instead. I know someone who has a form of dementia (luckily it’s the early phase, not so bad… yet) and it’s hard to see her declining. Slowly - but still. The worst is to see her struggling. She’s still healthy enough to be 100% aware of the situation. And I can see it’s hard. She’s a proud self-made independent woman who has had a great career in mens worlds and has been highly respected - always survived pretty much on her own. To see the strong, smart, witty and always prepared woman to lose her ever-so-tight grip on things is really sad. It’s no wonder many would rather just leave this world.

Coz he doesn't listen to his colleagues. He forgets he is part of A team, which is forever a bad idea.

And Dr Manning

Yep!

because she makes decisions based on emotions very frequently. Even Halstead gets "bashed". stop being pathetic.

Halstead is getting bashed. There's people in the comments pointing out that Halstead has went against a DNR or an advanced directive multiple times and always tries to undermine, Dr Charles, a trained and qualified psychiatrist, on subjects that he is an expert in. In reality, he'd have already lost his licence at this point. He wants to save people, but he goes against ethics to try and do it sometimes which isn't right. It would be one thing if it was ethically wrong but morally right which has happened a few times in Chicago Med. We'll disagree with them ethically but morally agree with them. Naturally, doctors want to save everybody they can, but that just isn't possible and it doesn't mean you can go against a DNR or an advanced directive to do that, especially if a psychiatrist says the patient isn't mentally fit to make their own decisions. That's extremely unprofessional. In Natalie's case, she is far too emotional and allows her emotions to influence her decisions and the advise she gives to patients about treatments. More than one patient has died because of Natalie's emotions. Advising against heart surgery that could of saved the patient's life that was recommended by a heart surgeon and recommending an alternative treatment that ended up killing the patient just because she felt bad for him isn't being a good doctor. She's very unprofessional. Both characters get bashed and deserve the hate that they get. If I said no to a certain treatment and a doctor did it anyway, I'd be pissed. If a doctor started being unprofessional and basing their advise purely on their own emotions, I wouldn't want to be treated by them either. Don't try and turn this into a gender thing when it has nothing to do with gender. Neither of them should still be doctors.

@@TomBentham thank you for typing this out, i couldn't explain my point any better!

Everyone except the hospital That´s why we get mad, because Will always gets scolded for decisions like this when allshe gets is a slap on the hand

As someone who lost many to Alzheimer's... My grandma would beg to die until the last stage. She was in a lot of mental pain, living in a nightmare. Crying, shouting in her sleep. Alzheimer's is the most evil condition for me. DNR orders are not legal in my country, if it was she would take it I think. I just hope I die before the last stage. Alzheimer's patients are not capable of making such decisions.what matters is what she wanted when she had free will. Alzheimer's takes your will and wishes.

I get what you mean, but imagine, in a moment of lucidity suddenly finding yourself in a hospital, in pain and struggling to breath. You already forgot that you have Alzheimer's and made that will. Then you see your loved ones beside you, medical personnel standing by, but they're not doing anything. You want to breath but they're just waiting there doing nothing to help you. What a horrible way to go out.

@@iagreewithyou3478 I agree. Anyone who didn't feel a sense of doubt at the moment she begs to be saved, would be a dangerous person I think. Yes it is a hideous illness to watch a loved one go through. The fact is though, that its all in the eye of the beholder. And people are making decisions when they get a diagnosis, based on fear of what may happen to them and fear that they will become so difficult to live with, that their families will suffer. It often makes me sad that people aren't assured they will have a dignified end to their life and will be cared for with respect and dignity until that happens. Maybe they would make a different decision. I doubt anyone gives them the opportunity or the option to consider that.

​​@@lulunz6809here is no dignity to advanced alzheimer's or dementia. You can barely speak, you can't recognize your loved ones anymore, you soil yourself regularly... It is not a dignified way to go and quality of life is also greatly reduced as the illness progresses. Not to mentiom that a patient with this diagnosis would likely not be safe to receive dialysis without restraints or sedation, since they could freak out and try to remove the shunt that connects them to the machine. (which isn't just in during dialysis, but usually stays in the arm) If I got this diagnosis, I would make the exact same choice: Write up a detailed advanced directive that specifies that I do not want any invasive life saving measures performed.

Sorry for your loss x

I think the show handled this part pretty accurately. It is a grey area, but it's also a clear cut case. Confusion, suspicion, outright paranoia, personality changes are all known "complications" of Alhziemers. It's a grey area, because we as a society are struggling to decide when a person no longer has the right to make choices for themselves. In many parts of the world, people have the right to make advanced directives and deny care for their future selves, knowing that their future self may no longer agree with that decision. In other parts of the world, that is not an option. This patient made the choice to make an advanced directive. As much as the concept of an advanced directive to refuse treatment is a grey area socially and morally, it's legally enshired and there is no need for an ethics panel. This patient made a choice, and the fact that her disease altered her choice was always possible. It's completely understandable that a doctor coming across situation for the first time (or second time, though he states it's "different", so first time for him), is horrified that her choice is locked in. He's stuck in the grey area. But the hospital has seen this situation many, many times. It's clear cut.

I don't know how it is in the US, but committees can take quite a time to convene, and a long time to reach a decision. Again, I don't know how it is in the US, but here, it would be uncommon to refuse advance care decisions, and would probably also require a lot of professional legal advice.

there not there relying on the patients choice before be drain went south

If that was the case why bother make a contract or signed a paper about it? The husband had the hardest one here, you don't know what agreement did the wife and husband came up with, im pretty sure the husband was the one who really wanted her to live on but the wife probably convinced her husband not to let her experience the complications of alzheimer's (not really to be taken lightly)

He asked her for verbal consent and she said yes Her rights and wishes still matter

​@@killianmmmoore I feel like it's pretty obvious why we would listen to the extensively documented wishes of someone with Alzheimer's when they are of sound mind versus them panicking when they don't know where they are.

She gave him permission to intubate at the moment, so this is no reason to sue.

@@kaitlintropper2061 He basically demanded that a woman with severe Alzheimer's would give him permission.

@@SoyDrinker It isn't just a black and white situation. The woman had a moment of realization, even though she had Alzheimer's, she still understood the concept of death and knew that she did not want to die. People with the illness aren't completely mentally shut down. And the doctor didn't "demand" anything, it was a question as to if she wanted him to save her life or not. If she wants to live, she should get that decision.

I’m sorry for your loss. My honest condolences.

Sorry for your loss x

I totally get what your saying my Mum fell ill March took till April to get her admitted on 3rd visit to hospital great nhs Britain Not..... she now has been diagnosed with vascular brain disease and parkinsons and now peg fed..... been passed around all over the hospital..... been a totally horrible time so sad I am x

Totally agree with everything you've said. My mum has dementia but if you spent a short time with her, you would think she's fine.

Exactly my point..people never understand the condition of primary caregivers..I am struggling with a mental health patient as my partner. Constant mood swings and rage drains me mentally to an extent that I feel totally lost. People only look at a couple of hours that they see these patients in the public, and don't understand how much the caregivers are struggling.

Big hug sent x

Early onset dementia? I’d hate to say it but it might be best to get your dad in a facility. My dad wasnt so agro but he would one day recall who I was and then another day not know who i was . His neighbour was like you describe your dad.. completely grumpy.. once I took the room tv guide and he just came up to me rolled it and wacked me on the head.. since they were all in a home.. nurses told me to let it go..I feel for your mum. It’s like having a grown up toddler not easy.

Because its a gray area. She very clearly had the will to live.

this is a certified JFC moment.

The same question goes especially for Natalie. She is even worse than Will by a bit. Pretty much everybody here deserve to have their license pulled at least 1,000 times at this point. The only person I feel wasn’t that bad is probably Dr. Charles and Goodwin.

@@cessnacitation-xwhat’s JFC

Because it's a TV program.

Nah if I'm at that point, dont listen and let me go.

It's like I would sign a paper to not follow anything after i my dementia worsen and only follow what I signed on the paper, I don't want to be medical help etc etc. Now it came to the time where she's suffering dementia and she's clinging on life. Why the fck would she sign paper? If this was the case then a contract could be easily breached because of one word.

It's really complicated 😰😰😰 I understand she has a previous documentation, but still, she must be so scary because the doctors are not helping her (at her point of view)

​@erilove593 from her point of view everything is scary. Her husband and daughter sometines appear as strangers pretending they're her family, doesn't know why or where she is at many points in the day. Her life is almost constant suffering and any moments of happiness are short lived, she has no present and no future and she forgets more of the past everyday. This is a nightmare for anyone and that is the reason she signed the advanced directive, no one should live like this

But should that one moment of possible lucidity ( which is more likely to have been paranoia) completely invalidate a decision that she for herself?.

@@louisemcdonald8613 yes, when they're back in normal Alzheimer's state then what happened 5 minutes before most likely no longer exists in their mind

As someone with a parent with dementia, you can't trust that momentary lucidity, because that's all it is momentary. The rest of the time their cognition is impaired and they can't do basic things for themselves. If it was my mother I would respect the directive she signed.

while i mostly agree with this i don't disagree with what he did in the episode: directly receiving verbal consent from a patient to save their life--especially with witnesses--seems like the right thing to do in this situation, i might be wrong

advanced directives are not things that can't be removed later on in time - patients have the right to change their minds at any stage. When it comes to receiving life saving procedures - they also don't actually need to understand the ins and outs of dialysis or have full cognitive capacity to consent to have their life saved. ethical decisions like this wouldn't have been left to one person in real life the way this show constantly depicts

That is a good point. I'm not sure about in the US however here you would have to have medical professional who is able to declare someone is competent to sign the advanced directive along and I would also have a legal professional to witness her signing the document and they need to sign it too. Also the AD should only come into play when the person can't articulate their wishes. I have had a family member die from a decision to stop giving her life saving medical care. Despite having a DNR, and her having a brain injury, they did their best to talk to her and she agreed to stop the dialysis and seemed to understand she would die however they also consulted with all of her children and the doctors agreed that to continue to treat her was futile. They didn't stop treatment until all of the children accepted and agreed it was futile to keep treating her. So it wasn't up to one person to decide to stop treatment despite one of the children having enduring power of attorney. It was a joint decision and everyone knew why it was happening and every attempt was made to involve her too regardless of her brain injury. The children cared for her at home until she died a week later. Advanced Directives need to be updated regularly because people change their minds. Even people with dementia until they stop having moments of clarity and understanding.

Not sure I follow. If she had a right to survive she won't be in the bed dying. So it seems that what you truly mean is that she has a right to get the best treatment available to prolong her life. The point is: She did not want to exercise that right. Is like buying an all-you-can-eat, maybe you can eat another burger (is your right as you have the capacity) but you don't wanna. Should the restaurant owner force feed you?

she also has a right of self-determination. what even is the purpose of advance directives and POAs if medical professionals would just ignore it

And then she sues and the doctors lose their licence

That's not right he should listen to her

@@naomiwatson8075 why? When she had the capacity to tell her wishes she didn’t want any of it

Nobody is always right

no dr. charles is not always right he's not the god

Why are those replies so stupid?

No think about how he acted when Reese went against the guy who shot him

okay very sorry. Dr Charles is right 99.7% of the time LOL

It’s a tough call though cause if she wasn’t diagnosed with alzheimers she would have stuck with her decision.

@@Saiyan_Steph that's why she made the plan, to protect her wishes.

@@marieantoinette1360 oh ur talking about dr Halstead my bad, sorry got confused

Well said.

Not everyone who uses a wheelchair can’t walk. The actor isn’t even disabled, I think he just had a knee injury while filming.

You can’t cure Alzheimer’s

It’s just a tv show you know?

@@__cherrie_outros_reqsclose1653 Not really...theres never gonna be too many doctors in the world. Currently, most doctors diagnose symptoms,and treat symptoms....a deeper look into the causes of said symptoms will require lengthy testing,team consulations etc...much like you see done on House M.D. Beyond that,doctors are people....they're not beyond labeling and judging books by the cover...they have to in order to see all the patients they gotta see.

@@DeMishMIsh Because you straight up can't cure alzheimers like hers, it's a destruction of neurons that we haven't properly researched.

There is no cure for Alzheimer’s

Not if the patient herseft signed a DNR (or whatever it is called, sorry, I'm not a native speaker) when she could still make decisions.

Afaik, the next of kin (the proxy decision maker) is always the spouse first. If there was no spouse, then adult children, etc. In real life, the doctor might have a meeting between the spouse and the adult children if they disagree on care. But at the end of the day, the spouse has the final say.

Interesting what did

@@yimwaili5425 I Mean the father does not want to help his wife

 What everyone is watch a cctv camera in the hospital

There's a difference between just saying "yes" and giving INFORMED consent.

The whole point is that the woman wasn't actually capable of giving consent to choose treatment, because of her Alzheimers. Being able to speak doesn't mean you're genuinely aware and understand what's going on. The fact was that when she was still of sound mind she *did* choose to sign an advanced directive stating she didn't want to be treated if she got sick.

You may not Trust your dad, but it's up to your mum who she trusts and wants to make the decisions not you.

She went home with her family to receive hospice care, I don’t think anything legal was perused by the family

Wrong! her dementia affected her thinking process and she wrote her wishes when she was well and gave her husband full power if she could no longer make her own decisions the dr is wrong and I'm sick of the times in this series he overrides patients wishes to do what he wants and i am happy he eventually loses his job in the series he is awful and dangerous and i hope i never encounter a doctor like this .

@aprilfisher4947 sh!t, sorry. I didn't watch full ep, I was talking ab what I saw on the clip. Sorry