The Unbefriended Senior

February 5, 2009 by  
Filed under Ethics In Action


210197_old_alone_manWhat is an “Unbefriended Senior? The “unbefriended” is a word used to describe someone who doesn’t have any friends or loved ones in their lives that the doctor can talk to when the patient is sick or injured. This term could also apply to someone younger without any family or friends.

Let me tell you about what just happened. An 80 year old woman collapsed at the market and was brought to the emergency room. She has had a massive stroke and may not live. The social worker looks through the patient’s wallet to find her insurance card and any information about who to contact in case of an emergency. Only the insurance card and an address are found. The social worker begins to make calls, goes to the patient’s house and tries to find anyone who might know this person. But nobody is found.

So what can the doctors do? If the patient gets better, then the patient will be able to speak for herself but if she doesn’t wake back up then the doctors will have to apply the “Best Interest Standard.” What is this? The Best Interest Standard is used when the healthcare team doesn’t know what the person would want and when nobody is available to talk to.

The healthcare team and possibly the bioethics committee will meet to evaluate what medical options are available for this patient. This way it is not just one person making the decision but a moral community. Next, there will be a discussion about the benefits and burdens of each of the options. Then they will do the best they can to decide what should be done. They may have to make the difficult decisions about dying and death for this person.

The other option for the healthcare team is to have the court assign a public or private conservator or guardian for them. This court appointed person will make their medical and/or financial decisions for the patient. But of course, they don’t know anything about this person either so the choice they will make might be wrong.

My question for you is, “Would you want a stranger to be making life and death decisions for you?”

If the answer is no, then please tell your doctor who they should talk to if you are injured, write it down in your wallet and fill out your Advance Directive. I don’t want you to ever be the unbefriended patient.

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