Serving the Underserved: Caring for People Who Are Both Old and Mentally Retarded: A Handbook for Caregivers

By Mary C. Howell; Deirdre G. Gavin et al. | Go to book overview
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MEDICAL ORDERS FOR THE DYING PATIENT: DO NOT ATTEMPT RESUSCITATION, LIMITS OF TREATMENT, AND RECOMMENDATION TO REMAIN IN RESIDENCE

Mary C. Howell

The physician's duties to the patient include taking all possible steps to ensure the patient's well-being. Certain dilemmas can be found in the enactment of this duty when the patient appears to be actively dying. For instance, is the dying patient's well-being enhanced by the use of an intravenous line, held in place by a needle or through a surgical incision in the skin, as a means of administering antibiotics to treat a pneumonia? If the patient, near death, refuses to take foods and liquids by mouth, is well-being enhanced by a tube inserted through the nose and threaded into the stomach to administer nourishment and fluids? (See Chapter 52)

People with mental retardation have, in the past, been deprived of needed and available medical care. This happened for a wide variety of reasons. Sometimes it was felt that the patient's "quality of life," as a person with mental retardation, was not worth living, and therefore no measures should be taken to prolong life. People with mental retardation were often incarcerated in institutions where they were kept out of sight and where adequate medical services were unavailable to them. And individual medical professionals often made judgments, such as "this retarded person is less than human," or "she can't really experience the pain," or "he would never be able to cooperate with the proposed treatment," that have summarily denied medical care to people considered to be intellectually incompetent. Any discussion of limiting medical

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