Pain Management in a Terminally Ill Patient with a Surrogate Decision-maker: A Challenge

Authors

Tausif Syed, Rochester Regional HealthFollow
Susan Mansourian, Rochester Regional HealthFollow
Pratyusha Tirumanisetty, Rochester Regional HealthFollow
Abdullah Abdullah, Rochester Regional HealthFollow
Richard Alweis, Rochester Regional HealthFollow

Department

Internal Medicine

Document Type

Article

Publication Title

Cureus

Abstract

When health care proxies are in charge of pain management, it may become very difficult to address the patient's pain if the health care proxy has misconceptions about analgesics. We report a case of an 87-year-old lady who was found to be pulseless, and after successful cardiopulmonary resuscitation (CPR), was intubated and remained so for over a month in the intensive care unit (ICU). The medical team could not provide the patient with pain medication, as the daughter who was the surrogate decision-maker did not allow the administration of any pain medication in the false belief that it would kill the patient. This case helps us to shed light on the surrogate decision-maker and pain management and how medical professionals can solve similar issues in the future. Early consultation with palliative care may be beneficial. For continued disagreement, the ethics committee should be consulted.

First Page

e5429

DOI

10.7759/cureus.5429

Volume

11

Issue

8

Publication Date

10-22-2019

Recommended Citation

Syed, T., Mansourian, S., Tirumanisetty, P., Abdullah, A., & Alweis, R. (2019). Pain Management in a Terminally Ill Patient with a Surrogate Decision-maker: A Challenge. Cureus, 11 (8), e5429. https://doi.org/10.7759/cureus.5429