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29. Case: Complicated Caring
View Case Study: 29. Case: Complicated CaringMr. Sundown is a 78-year old African Nova Scotian who is a patient in an internal medicine clinical unit at the Halifax Infirmary. He has a variety of serious medical conditions including diabetes, coronary artery disease, and advanced COPD. He is experiencing progressive respiratory failure on the basis of a difficult-to-treat pneumonia. Mr. Sundown has…
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24. Case: Changing Care and Care-Giving
View Case Study: 24. Case: Changing Care and Care-GivingKevin Henderson is an 83-year old man who is hospitalized in an internal medicine clinical unit at the local hospital. Kevin has a variety of serious medical conditions including severe Alzheimer’s disease, diabetes, coronary artery disease and advanced chronic obstructive lung disease. He is slowly recovering from a difficult-to-treat pneumonia, which required treatment with intravenous…
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20. Case: To Treat or Not to Treat
View Case Study: 20. Case: To Treat or Not to TreatStan Miller, a retired widower, sustains severe burns covering 80% of his body surface in a house fire secondary to a propane gas leak. He is initially assessed in the ED of the local hospital where he is sedated and intubated without any pre-resuscitation discussion about the seriousness of his thermal injuries and his care…
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18. Case: When the “Truth” is Painful
View Case Study: 18. Case: When the “Truth” is PainfulMrs. Sally Parrot, a 73-year old widow, has mild dementia of a presumed neurovascular type. She resides in her own small apartment in Serenity, a private continuing care community in Bedford, where she receives some assistance with housekeeping, meal preparation and organization of her medications. Sally is actively engaged in Serenity’s structured activities and, in…
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15. Case: Acceptable Judgement?
View Case Study: 15. Case: Acceptable Judgement?Sara Thornton, an unemployed 19-year old woman, lives with her 28 year old sister, Fran, and Fran’s boyfriend, Alan. Both sisters were diagnosed with bipolar I disorder in their mid-adolescence. They are both estranged from their alcoholic mother, the only living parent. Fran has learned to manage her illness reasonably well through lifestyle changes, participation…
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14. Case: I Want to Go Home!
View Case Study: 14. Case: I Want to Go Home!A widower (age 88) lives alone, but has family living nearby. Recently he had a stroke and regained consciousness after being admitted to hospital. He was deemed to have cognitive capacity. His adult children approached the physician in charge of his case along with the unit’s Nurse Manager and requested that the patient be placed…
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13. Case Mind Over Matter?
View Case Study: 13. Case Mind Over Matter?Essie Marshall is well-known in the community for her many years of dedicated volunteer work and leadership. She is also well-known in the emergency department for her frequent visits. As one of the doctors describes her, “She’s a challenging patient, but not in the medical sense.” Today Essie is back in the emergency department, saying…
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6. Case: To Feed or Not to Feed?
View Case Study: 6. Case: To Feed or Not to Feed?You receive a call on the ethics line about a patient’s relative (next-of-kin and legal decision-maker) force-feeding her sister who is a patient on the unit (pushing food into the patient’s mouth and then holding her mouth closed, pinching her nose, etc. until she swallows). Apparently, this was not an uncommon approach to getting her…
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5. Case: Caring for a “Difficult” Patient
View Case Study: 5. Case: Caring for a “Difficult” PatientA female patient in her mid-forties has been on the GI service for several months now due to severe Crohn’s Disease, which has left her with multiple draining abdominal fistuli. She has recently moved out of the province but her condition could not be treated adequately in the local hospital so she was transferred back…


