Say Cheese!

Upon return from a vacation, Jonathan’s manager calls him into her office. Some of the photos he posted on Instagram while he was away have caused a stir. There are pictures of him posing on the beach with friends. Everyone has a drink in their hands. There are a number of candid shots of parties…

Purely medicinal

Colleen is a home care worker who has been looking after Mr. J for several months. He is an elderly widower who is housebound. His social interactions are limited to his home care workers, and weekly visits from his son and daughter-in-law, who bring him groceries and library books. Colleen has found Mr. J to…

What should I say?

It is late at night and the phone rings. The caller identifies herself as the mother of Jane, a patient on the unit. Jane was admitted involuntarily the day before after being rescued from a bridge, from which she was preparing to jump. Jane has not verbally communicated with anyone since her admission, but having…

Playing God

This month’s case was inspired by a request for information on the ethical considerations around resource allocation. Coincidentally, a relevant article appeared in the New York Times recently that illustrates the significant challenges we face in health care, when trying to find the fairest way to give ideal care. First, though, a few things to…

Feast or Famine

Mr. Jones is living with advanced dementia. He no longer communicates verbally or feeds himself. In fact, he actively resists being fed by staff at the personal care home where he has lived for several years. He clamps his mouth shut and turns his head away from the food when it is offered. His wife…

“Please, help me die…”

Andrea is providing home care for Jason, a young man with a number of health conditions, including a long recovery from a serious car accident that has resulted in mobility limitations, chronic pain, and major depression. Over the past few months he has mentioned wanting to die several times. Today, he says, “Now that it…

Visiting Hours

Michelle’s frail elderly father, Tom, was admitted to hospital following a fall. He had been living with Michelle and her family since a stroke two years previously. Prior to the fall, he required significant care, but Michelle was able to manage with the support of her siblings. Among Tom’s challenges were a moderate language barrier,…