Angela is a 72-year-old woman with end stage congestive heart failure from coronary artery disease–she has had two myocardial infarctions. When her medical management is optimal, she is just able to take care of herself in her own apartment, but with any small decompensation, she ends up in the hospital. She comes in for a clinic visit, and her weight is up 2 kilograms and she is complaining of paroxysmal nocturnal dyspnea, even though she has been taking her meds as prescribed. Exasperated and discouraged, she asks, “Am I dying”? The cardiologist replies: “Well, no–this is all reversible.”
What would you, as the medical-legal consultant/ethicist, say to
Angela?
