Friday afternoon ethics consult: The patient, an elderly man with terminal
colon cancer, had been rehospitalized for septicemia several weeks after a
palliative procedure to remove the threat of obstruction. Things were not
going well with Mr Dean. Yes, the antibiotics seemed to be doing their job
and yes, his temperature was down, but George Dean had become more agitated
than ever, especially at night, and kept pulling out his gastric feeding tube.
Meanwhile, the surgical resident kept replacing it, albeit none too happily.
After a day or two of this, the attending surgeon had ordered upper-body and
wrist restraints to prevent his patient from pulling out the tube. Thereupon
the nursing staff requested an ethics consult because they thought it might
be unethical to use restraints in this situation.
Coulehan J. Attention Must Be Paid. JAMA. 2000;283(8):976. doi:10.1001/jama.283.8.976
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