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A Piece of My Mind
August 26, 2009

The Other Person

JAMA. 2009;302(8):832. doi:10.1001/jama.2009.1263

Mrs Albersmith's (not her real name) health had been declining—she had a history of liver disease, slowly progressive dementia, and now, at age 83, a major stroke that had left her paralyzed and a shell of the vibrant woman she once was. I was consulted to discuss goals of care and hospice, although decisions had been made prior to my arrival—the family just needed support and reassurance that what they (and Mrs Albersmith) had decided was clinically and ethically acceptable. An advance directive had been located that indicated she did not want artificial nutrition or hydration, and now with a nasogastric tube firmly taped in place, the decision had been made to forgo placement of a percutaneous endoscopic gastrostomy and to remove the nasogastric tube.

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