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Case: Mrs. Taylor is a 68-year-old African American female with advanced multiple sclerosis (MS), hypertension, diabetes II, dementia, and osteoporosis, who has been unable to swallow food or fluids for three days now and has developed a fever and vague symptoms of respiratory distress. She has resided in the nursing home for the past three years. She has not been ambulatory for two years and has speech difficulties due to her MS. A chest x-ray was ordered and showed a right lower lobe infiltrate. She is unable to make decisions about her care and has no advanced directive. Her family is contacted, and they agree to antibiotics but not hospitalization or a feeding tube. Although neither of her two sons has seen her recently, they both report that after her diagnosis of MS, she had many discussions with them about no heroic measures.
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