Abstract:
A fire chief taking an Emergency Medical Services (EMS) Division shift for one of his firefighters receives a call about a man with a gunshot wound. When he arrives on the scene, the chief recognizes the mother of a childhood friend. Her father-in-law has shot himself in the head. The patient has a terminal illness and Alzheimer's disease. The daughter-in-law produces the patient's living will, which declares his wish not to be resuscitated. But state law does not recognize living wills or do-not-resuscitate orders outside of a hospital setting. The daughter-in-law begs the chief not to resuscitate the patient. To respect the family's wishes, the chief breaches protocol and agrees. But the patient's vital signs improve and the chief is required to take him to a hospital. The family wants the patient to die at home, but the chief could lose his paramedic license for not providing proper care. He decides to withhold invasive treatment, but when he calls the nearest hospital on the ambulance radio, he is instructed to provide complete advanced life support. The patient's family is distraught and feels betrayed. He is faced with the conflict of how to honor the wishes of the patient and his family, while not jeopardizing his career.
