15th March 2022

You are the registrar on call for a respiratory high dependency unit

You are the registrar on call for a respiratory high dependency unit. One patient on the unit had been admitted two days previously with severe hospital-acquired pneumonia. He has AIDS, and end-stage Kaposi’s sarcoma, with lung involvement, and is requiring non-invasive ventilation to support his respiratory function. A DNACPR is in place.

You are called to review him in the middle of the night – he is in significant respiratory distress, and the junior doctor and nurses looking after him tell you that they just can’t seem to stabilise him. The patient is conscious, and beckons you over. He pulls off his mask, and is able to tell you that he is “tired, I’ve had enough, I want to take this off even if it kills me”. This action would likely lead to the death of the patient, and due to your religious beliefs you do not feel you can sanction withdrawing this treatment.

Which of the following is the best course of action?

Select the SINGLE most appropriate option from the list below. Select ONE option only.