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Earlier this year, we asked readers to consider and comment on withholding last-line antibiotics in a terminal patient with traumatic brain injury (JW Hosp Med Jan 24 2011). Many readers contributed their opinions. Below, a medical ethics team from Grady Memorial Hospital in Atlanta, Georgia, responds to this case.
Questions: Can we ethically justify withholding last-line antibiotics in this patient? Can we protect use of this antibiotic so that bacteria don't become resistant to it, with the hope that it will work in subsequent patients with substantially better chances of positive outcomes?
Physicians confront patients who lack decision-making capacity on a daily basis and, as a result, must look to authorized decision makers for guidance i…