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Posted on July 26, 2018 at 5:00 AM

The Healthcare Ethics Consultant-Certified (HEC-C) program is the first-ever certification program that identifies and assesses a national standard for the professional practice of clinical healthcare ethics consulting. The first round of testing is November 2018. Fifteen sample questions, like the one below, are now available.  

A 71-year-old woman is hospitalized in the ICU with acute respiratory failure requiring mechanical ventilation and sedation. She has a long history of emphysema requiring long-term oxygen therapy, in addition to peripheral vascular disease and stable angina pectoris.

She was admitted a week ago for mild respiratory distress. In conversation with her husband and the physician during that admission, she voiced that she did not want life support treatment, including intubation, due to her poor quality of life. The physician documented the decision and placed a DNAR order in the hospital chart. She was subsequently discharged home with no order in force limiting treatment.

Today when she developed trouble breathing at home and passed out, her husband called 911 and insisted that the paramedics intubate her on arrival to their home. The paramedics complied with the request. Now in the ICU, her husband is insisting that she continue to receive aggressive life-sustaining treatment. The patient does not have decisional capacity.

The medical team calls for an ethics consult, requesting support for the continuation of the DNAR. What is the underlying ethical standard guiding the HEC analysis of this case?

A.  Substituted judgment
B.  Best Interests
C.  Surrogate decision-making
D.  Beneficence

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