Ethics for Lunch: Providing Information to Patients about Extracorporeal Membrane Oxygen (ECMO)
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B.F. is a 60-year-old woman with a past medical history of diabetes and asthma who was admitted to a community hospital with community-acquired pneumonia. She was placed on intravenous antibiotics and steroids for an asthma exacerbation. She required supplemental oxygen. Despite these measures, her lung condition progressively worsened, and she needed to be intubated and placed on mechanical ventilation. She required sedation to tolerate the ventilator. When she developed signs of Adult Respiratory Distress Syndrome, a decision was made to transfer her to Johns Hopkins Hospital for consideration of Extracorporeal Membrane Oxygenation (ECMO).
The patient is married and has three adult children who live nearby. Her family has been actively involved in her hospital care and visits her at JHH. Her husband is her surrogate decision maker and is approached by the ECMO team to discuss placing her on ECMO while the ICU team manages the ARDS and her other comorbidities. In addition to reviewing the consent form for ECMO with
Mr. F, the ECMO attending physician gives her husband an Information Sheet about ECMO and the clinical evaluation process.
- What is contained in the ECMO Information Sheet?
- What is the intent of providing the Information Sheet in addition to the consent form?
- How will the form be used over the course of the patient’s hospitalization?
- What is the usual process for obtaining consent to initiate ECMO?
- What clinical parameters are used to make decisions to discontinue ECMO support?
- Discuss the importance of informed consent forlife-sustaining technologies like ECMO.
- Describe the development process of an Information Sheet for patients and families to understand what ECMO involves.
- Define medically ineffective treatment and the process for when it might be invoked with regard to ECMO.