CHARLES O'BRIEN was brought to the hospital
at the age of 77. Mr. O'Brien had a stroke at age 70 which left him mildly
incapacitated. At age 73 he was diagnosed with lung cancer and his left lung was
removed. At the time Mr. O'Brien suffered considerable depression because of his
failing health. At 75 he suffered another stroke which left him paralyzed on the
left side and with very little ability to speak. He seemed to be mentally alert,
however, and he could communicate but with considerable difficulty. Before his
hospitalization he was nutritionally compromised and suffered increasingly from
incontinence of both bowel and bladder. This hospitalization resulted from a
cardiac arrest he had at home. The life squad was able to restore his heartbeat
and his mentation has returned to decently close to its pre-hospital state.
While in the hospital, Mr. O'Brien had some tests run which indicate that he now
has cancer in his right lung. His wife and brother had been taking care of him
at home and now they are managing his care in the hospital. They have told the
physician that they do not want Charles to be told about the cancer because they
fear he will go into a depression as he did with the previous cancer diagnosis.
However, they do want Charles to have radiation therapy for his lung cancer ---
no surgery is possible this time. They have also told the doctor that they want
Charles to be DNR. None of these decisions have been discussed with Mr. O'Brien
nor has an advance directive ever been discussed with him.