Question: Abdul Was A Retired Engineer In His Late 50s With A Wife And Two Adult Children. He Entered Hospital As A Relatively Healthy Man For The Removal Of A Benign Brain Tumor, Contracted A Brain Infection Following Surgery And Became Comatose, Requiring Intubation And Mechanical Ventilation. Two Of His Treating Doctors Eventually Came To The Conclusion That …

Abdul was a retired engineer in his late 50s with a wife and two adult children. He entered hospital as a relatively healthy man for the removal of a benign brain tumor, contracted a brain infection following surgery and became comatose, requiring intubation and mechanical ventilation. Two of his treating doctors eventually came to the conclusion that Abdul would never regain consciousness and advised that the ventilator and feeding tube keeping him alive and requiring around-the-clock care be removed. Propelled by her religious beliefs, his wife sought an injunction to stop the doctors from ending life support. Abdul had no advance directive; there was no written indication of his wishes. Abdul’s physicians contended that if the court granted the family’s request, they would be forced to act against their professional and ethical obligations to “do no harm” by maintaining a biologically alive man in a state of living death. The physicians maintained that the treatment being provided to Abdul was akin to torture. Abdul’s nurses, too, who provided his care in 8- to 12-hour shifts, were placed in a compromising position. This case raises particular ethical issues about appropriateness of care (futility), conflict of conscience, causing harm to a patient without subsequent benefit, and the cost of health care that is considered futile.