This article presents the case of a critically ill woman whose decisional capacity was impaired by delirium. She indicated that she wanted to die, although it was not clear if she wanted life support withdrawn or was passively wishing for death. Family members were quite upset and attempted to terminate the evaluation. The patient slowly recovered physically and returned to her cognitive baseline. The author discusses this case with a focus on decisional capacity, delirium, and family and staff relationships.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
2.
American Thoracic Society. (1991). Withholding and withdrawing life-sustaining therapy. Annals of Internal Medicine, 115(6), 478-485.
3.
Curtis, J. R., Patrick, D. L., Shannon, S. E., Treece, P. D., Engelberg, R. A., & Rubenfeld, G. D. (2001). The family conference as a focus to improve communication about end-of-life care in the intensive care unit. Critical Care Medicine, 29(Suppl. 2), N26-N33.
4.
Jacobson, S. A. (1997). Delirium in the elderly. The Psychiatric Clinics of North America, 20(1), 91-109.
5.
Novick, R. J., Stitt, L. W., Al-Kattan, K., Klepetko, W., Schafers, H., Duchatelle, J., et al. (1998). Pulmonary retransplantation: Predictors of grant function and survival in 230 patients. The Annals of Thoracic Surgery, 65, 227-234.
6.
Omnibus Budget Reconciliation Act, 42 U.S.C. § 4751 (1990).
7.
Organ Procurement and Transplantation Network. (2003). All Kaplan-Meier median waiting times for registrations listed: 1996-2001. Retrieved May 23, 2003, from http://www.optn.org/latestData/rptStrat.asp
8.
Prendergast, T. J. (2001). Advance care planning: Pitfalls, progress, promise. Critical Care Medicine, 29(Suppl. 2), N34-N39.
9.
Upadya, A., Muralidharan, V., Thorevska, N., Amoateng-Adjepong, Y., & Manthous, C. A. (2002). Patient, physician, and family member understanding of living wills. American Journal of Respiratory and Critical Care Medicine, 166, 1430-1435.
