Do Family Wishes Trump Verbal Advance Directive?

An Ethics Case Report Amidst COVID Pandemic

Abstract

COVID 19 has brought about a complex array of clinical as well as ethical challenges for the healthcare community around the world. We are reporting a case, managed by a team of experienced clinicians at a local tertiary care hospital, where the patient’s wishes conflicted with those of the family. The case under discussion may be approached from legal, social, and clinical perspectives. However, the lessons learned range from an individual to the policy level. The issue of the validity of a verbal advanced directive by the patient was called to attention when the patient lost the capacity and the wishes of his family conflicted. Effective communication with patients and their families, adequate documentation, and prompt involvement of a clinical ethics committee are recommended to avoid conflicts. The significance of ethics education and clinical/hospital ethics committees in healthcare organizations cannot be undermined.