Mrs. Finn

Mrs. Finn is an 80-year-old woman, with non-resectable lung cancer, diabetes, hypertension, chronic renal insufficiency, and severe degenerative joint disease. She was stable, walking short distances with a walker, fully cognizant, and living in a retirement center until 2 days prior to admission when she became markedly short of breath. She was diagnosed with lobar pneumonia. Mrs. Finn has three children and eight grandchildren. She had not written a living will and is very religious, wishing to leave her fate to a higher being.
Despite initial improvement with treatment, Mrs. Finn. developed high fevers and septicemia on her third day of hospitalization. Stronger antibiotics, vasopressors, and fluids did not prevent worsening hypoxemia. She developed acute renal failure and lost full mental capacity despite aggressive treatment. Her family has asked that “everything be done.” Physicians realize Mrs. Finn. needed dialysis and intubation to prevent imminent death. Given her incurable lung cancer, it was unlikely that Mrs. Finn would ever be extubated. Under the best circumstances, she would not return to semi-independent living and would face continued pain and further decline from her cancer. The family still requested full treatment, saying they are hoping for a miracle, but will settle for as much time as they can get with their mother while she is still alive. The residents are frustrated and divided on the issue of whether Mrs. Finns care is futile.