Honor wishes of patients and their families

Issue: BCMJ, vol. 53, No. 10, December 2011, Page 520 Letters

Should advanced medical knowledge supersede a patient’s family’s wish? Recently a patient of mine was admitted to hospital for a severe illness. After about 2 to 3 weeks he had to be transferred to the intensive care unit. While in hospital several meetings were held to discuss the code status. The entire family insisted on “full code.”

One night, the patient suddenly passed away in the ICU and no code was called. The members of the family asked why there was no code. The doctor said that the patient would never make it anyway, so no code call was appropriate. 

Medically I might agree that the patient had a terminal illness with several complications, and he most likely would not survive.

However, the doctor’s judgment should never supersede the collective and unanimous wish and request of the patient’s family. As a physician one should try one’s best, and the wish of the patient and his family should definitely be honored and respected.

I welcome other physicians’ comment.
—Francis Ho, MD
Vancouver

Advance directives gained legal status on 1 September 2011. Written consent for (or refusal of) health care made by a patient to a health care provider is now legally binding. For more information visit https://www.bcma.org/news/advance-directives.
—Ed.

Francis Ho, MD,. Honor wishes of patients and their families. BCMJ, Vol. 53, No. 10, December, 2011, Page(s) 520 - Letters.



Above is the information needed to cite this article in your paper or presentation. The International Committee of Medical Journal Editors (ICMJE) recommends the following citation style, which is the now nearly universally accepted citation style for scientific papers:
Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.

About the ICMJE and citation styles

The ICMJE is small group of editors of general medical journals who first met informally in Vancouver, British Columbia, in 1978 to establish guidelines for the format of manuscripts submitted to their journals. The group became known as the Vancouver Group. Its requirements for manuscripts, including formats for bibliographic references developed by the U.S. National Library of Medicine (NLM), were first published in 1979. The Vancouver Group expanded and evolved into the International Committee of Medical Journal Editors (ICMJE), which meets annually. The ICMJE created the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.

An alternate version of ICMJE style is to additionally list the month an issue number, but since most journals use continuous pagination, the shorter form provides sufficient information to locate the reference. The NLM now lists all authors.

BCMJ standard citation style is a slight modification of the ICMJE/NLM style, as follows:

  • Only the first three authors are listed, followed by "et al."
  • There is no period after the journal name.
  • Page numbers are not abbreviated.


For more information on the ICMJE Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals, visit www.icmje.org

BCMJ Guidelines for Authors

Leave a Reply