Phil B.FontanarosaMD, Deputy EditorIndividualAuthorStephen J.LurieMD, PhD, Contributing EditorIndividualAuthor
To the Editor: Dr Goold and colleagues1 have presented an appealing approach to family-physician
conflict, which is likely to be an improvement on the unschooled but well-intentioned
efforts that are generally used.
However, the case they present is so shocking in its inattentive pattern
of routinized inadequate care that it should not pass without comment. The
patient had Alzheimer dementia and was hospitalized with recurrent aspiration
pneumonia. His son and daughter-in-law provided daily care and wanted him
to live out his days at home. A consulting gastroenterologist and a resident
who treated the patient on "several prior hospitalizations" for pneumonia
agreed against inserting a feeding tube. However, the family wanted "everything
done," including a feeding tube and resuscitation if necessary.
Lynn J. Handling Conflict in End-of-Life Care. JAMA. 2000;283(24):3199-3200. doi:10.1001/jama.283.24.3198