Behavioral Science & Ethics USMLE Step 1 Practice Question
A 78-year-old man with advanced dementia presents to the ED in respiratory distress. Vital signs: BP 128/76, HR 102, RR 28, SpO2 78% on room air. Chest X-ray shows bilateral infiltrates consistent with pneumonia. He denies chest pain. His living will explicitly states he refuses intubation. His daughter demands aggressive intervention and intubation. He is not on mechanical ventilation currently. What is the most appropriate action?
Answer choices
- ADischarge the patient
- BIntubate per daughter request
- CFollow the living willCorrect answer
- DConsult the ethics committee before any action
- EWait for another family member
- FInitiate non-invasive positive pressure ventilation as a compromise between the living will and family wishes
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