Case Study: Disagreement Over Advance Directive

80-year male with multiple medical problems with esrd, dementia, stroke, bedridden and with low blood pressure. Not responsive to medical team. Pt 2010 Advance Directive states, “if only artificially prolonging life and no meaningful interactions with family…withhold treatments”. Medical team believes the clinical situation is at this point, daughter (DPOA) disagrees. Daughter is primary caregiver, quit work to care for her father. Siblings disagree with her and think they should move to comfort measures. A second opinion for determination of non-beneficial care had nephrologist disagree with approach by the medical team, but agreed care was non-beneficial.

Question: Do you do another round of dialysis?

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