John H., a 28-year-old truck driver, was admitted to the ED by his girlfriend (whom he had named his durable power of attorney for health care about six months earlier). He was confused, incoherent, his movements were uncoordinated, he was jaundiced and had an acutely distended abdomen. John had a 10-year history of very heavy drinking.
John was taken to surgery in a metabolic coma. Surgery found that the small bowel and colon were densely matted to one another and to the abdominal wall. In all areas, there was acute and chronic inflammation. There was persistent oozing from all surfaces with no apparent surgically amendable area. Given these findings, John's abdomen was packed tightly with pads and closed with large sutures. He was sent to the ICU in critical condition on a ventilator with a diagnosis of multisystem failure, septicemia, cirrhosis of the liver and coagulation defect.
After surgery, the surgeon informed John's mother (John's girlfriend had run home to check on her two children) that John's prognosis was bleak and his chances of survival were "minimal." John's mother said she wanted all treatment stopped. When John's girlfriend heard about this several hours later, she was furious, and insisted on aggressive treatment and a second surgical opinion.
John continued to bleed and generally deteriorate over the next several days, but his girlfriend continued to demand that everything be done, including administration of blood products, dialysis, and CPR in the event of a cardiac arrest. She claimed that stopping treatment would be immoral and against the tenets of her Catholic faith. John's mother continued to vehemently oppose treatment.
The physicians caring for John agreed with the mother (with the exception of the nephrologist who agreed with continuing dialysis). The primary physician avoided John's girlfriend and spoke almost exclusively with his mother about John's medical condition and prognosis. However, because of the conflict between the mother and the girlfriend, and the fear of a lawsuit, the primary physician opted to continue treatment. He didn't "want to end up in a courtroom over this case." Aggressive treatment continued. John died two-and-a-half weeks later, never having regained consciousness, after a 45-minute attempt at resuscitation. (Source: Unknown).