Jean McGuire is a
seventy-one-year old profoundly mentally disabled woman with the mental age of
a two year old. A lifelong resident of a state institution, she was
hospitalized because of a mild fever that resisted standard treatment. She has been in the hospital for nearly three
weeks undergoing a battery of invasive and uncomfortable diagnostic procedures:
two bone marrow biopises, a barium enema, and a fine needle lymph node bipsy
had all been performed, and their results had been inconclusive. Ms. McGuire
has been placed with a PEG tube because she had been losing weight. After some of her worst experiences, Ms.
McGuire had been seen whimpering and crying for days. She spends most of her
time in the hospital curled up in a fetal position, with the blankets drawn
over her head. Before her hospitalization Ms. McGuire was reported to be
capable of enjoying the company of others and enjoyed the facility she resided
in. The director of her facility said that she reacted with obvious displeasure
during even routine medical examinations, often needing to be held by an
assistant. Though the physicians are unsure of her exact diagnosis, they
suspect she has high grade large-cell lymphoma. Treatment for this would
include six to eight course of chemotherapy with its burdensome side-effects.
With treatment, up to 70 percent of patients have measure improvement of symptoms,
but only 30 percent can expect long-term remission. Ms. McGuire’s physicians
and facility direct wonder whether the treatment will do more harm than good.
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