Events

Case:

A.L. is a 45-year-old male who was admitted with a past medical history of HIV and esophagitis and presented after being found down. He was intubated upon arrival and transferred to the MICU. Over the first few days, social workers attempted to locate the family without success. The medical team attempted extubation, but the patient didn’t tolerate it, so the team began to consider tracheostomy and PEG tube placement. Both procedures were considered elective, though necessary in the near future to decrease potential damage from prolonged placement of nasogastric tube and endotracheal tube.

Questions:

1. What criteria are used to determine if guardianship should be pursued?
2. What is the guardianship process?
3. How long might it take to obtain a guardian?
4. What do you do if multi-disciplinary team members disagree regarding the need for guardianship?
5. When should the Ethics Service be consulted in a guardianship case?

Learning Objectives:

1. Understand why guardianship is obtained.
2. Describe the criteria for guardianship.
3. Discuss when an Ethics Consult may be beneficial to the team during the guardianship process.