Mr. Martino’s respiratory rate decreases, and he seems more comfortable. He becomes less alert, and as he becomes more lethargic, his secretions increase.
His wife becomes alarmed and says she hears the ”death rattle” that her mother had before she died. She asks you to do something to prevent him from dying. She just remembers that he always said he wanted to attend his daughter’s confirmation, which is next week. She asks you to please do something to keep him alive for the confirmation. She states he was intubated for respiratory distress a few months ago and went home 5 days later.
The 12 year old daughter is crying, and the patient’s wife is becoming agitated. Mrs. Martino tells you she has changed her mind about making him comfort measures only and though she believes that there is nothing reversible to treat today, she “wants everything done” to keep him alive for the daughter’s confirmation. She points out that her father had a DNR/DNI code status at one point, but later reversed it when his wife got sick, so she knows these decisions are not permanent.
What do you do?