What Would You Do? Ethics in Emergency Medicine
By Bernard Heilicser, DO, MS, FACEP, FACOEP-D

The following dilemma was presented to us by an emergency department physician.

An 81-year-old female was transported to the emergency department by EMS after an attempted strangling. It appeared that her husband attempted to euthanize her by strangulation with a belt. The family discovered the situation and called EMS.

In the ED, the patient indicated that she had terminal breast cancer and was prepared to die. She refused all labs, IVs or treatment. The ED physician was unsure what his obligations were and what to do.

If clinically stable, should the patient be discharged? Is there a need for psychiatric intervention or consultation?

What would you do?