“The most important decision an individual can make may be how much treatment they want at the end of life.”

photo from pxhere

When it comes to end-of-life decisions, it may be hard for a nurse to accept to support only what the patient wants, but it’s also vitally important. In the Viewpoint column in our June issue (Viewpoints are free to read), Nadine Donahue, PhD, RN-BC, CNE, describes caring for an elderly patient in his home as he begins to lose the ability to breathe on his own because of COVID-19.

When she implores the normally spry, physically active retired executive to let her call an ambulance to take him to the ED, he refuses. Writes Donahue, an associate professor of nursing at York College, City University of New York:

“He’d always told me that he believed in a time to be born, a time to live, and a time to die. He was not going to be attached to a ventilator and in a hospital if he could help it.”

Honoring his wishes, no matter the risk.

The author finds herself struggling with her own instincts as a nurse to find a way to save this man she has come to know well over years of helping him to manage a heart problem. She knows well enough that his refusal of hospitalization isn’t based on a whim and that his thinking and priorities have always been clear and sharp.

Read the short one-page essay, “Respecting End of Life Decisions,” to learn the outcome. You’ll draw your own conclusions, but one point Donahue seems to be making through telling us this story is that nurses and physicians, skilled in the arts of cure and comfort and prevention, nevertheless may not always know what’s best for every patient. But even when they are sure they do, they are ethically bound to respect the patient’s wishes. And out of this effort may appear a kind of reconciliation of opposing forces or ideas.