ARTICLESRespecting Patient Autonomy Versus Protecting the Patient's Health A Dilemma for Healthcare ProvidersBadger, James M. PhD, APRN, BC; Ladd, Rosalind Ekman PhD; Adler, Paul Esq Author Information Author Affiliations: Departments of Nursing and Psychiatry, Rhode Island Hospital (Dr Badger); Brown University Medical School, Providence (Dr Ladd); Deputy General Counsel, Rhode Island Hospital, Providence, Rhode Island (Mr Adler). Corresponding author: James M. Badger, PhD, APRN, BC, Departments of Nursing and Psychiatry, APC 948 Rhode Island Hospital, 593 Eddy Street, Providence, RI 02903 ([email protected]). JONA's Healthcare Law, Ethics, and Regulation: October 2009 - Volume 11 - Issue 4 - p 120-124 doi: 10.1097/NHL.0b013e3181c1b542 Buy CE Test Metrics Abstract A 74-year-old man with multiple chronic medical problems was hospitalized for respiratory distress. He experienced recurrent aspiration and required frequent suctioning and endotracheal intubation on several occasions. The patient was deemed competent and steadfastly refused feeding tube placement. The patient demanded that he be allowed to eat a normal diet despite being told that it could lead to his death. The patient wanted to go home, but there was no one there to care for him. Additionally, neither a nursing home nor hospice would accept him in his present condition. The case is especially interesting because of the symbolic value of food and the plight of the patient who has no alternative to hospitalization. The hospital staff experienced considerable stress at having to care for him. They were uncertain whether their obligation was to respect his autonomy and continue to provide food or to protect his health by avoiding aspiration, pneumonia, and possible death by denying him food. This ethical dilemma posed by the professionals' duty to do what is in the patient's best interest versus the patient's right to decide treatment serves as the focus for this case study. Ethical, legal, and healthcare practitioners' considerations are explored. The case study concludes with specific recommendations for treatment. © 2009 Lippincott Williams & Wilkins, Inc.