[Solved]: Jimmy Lomond is a 5’9”, 53 year-old male who weight…

Jimmy Lomond is a 5’9”, 53 year-old male who weight 623 lbs. He suffers from serious chronic heart problem without a heart transplant is likely to die in a few weeks or months. However, due to his weight, he is not an acceptable candidate for a transplant. He is in an intensive care unit and is usually unaware of his surroundings; when he seemed conscious, he talks incoherently. Hiss 69-year-old mother, Eva Lomond, is his surrogate decision maker. Mrs. Lomond rejects the notion that he is dying. When Jimmy was an outpatient for several months, they were told that unless he loses significant weight, he will die in early death. Mrs. Lomond believes that Jimmy’s weight is his major problem and rejects the idea that his heart is failing. She thinks his heart is ‘overstressed’ due to his weight. Since she does not remember hearing anything about heart failure three months ago, she believes that the healthcare team simply does not want to treat a person whose weight makes him difficult to handle. There is a consensus in the healthcare team that CPR would not be successful for a person with Jimmy’s cardiac illness and size, and that in all likelihood CPR itself would kill him. However, Mrs. Lomond insists on a full code, claiming, as is her usual statement, but the team does not want to do CPR on Jimmy because it would inconvenience them. Since Mrs. Lamont is unrealistic about Jimmy’s heart condition, the team has decided to tell Mrs. Lomond that CPR does not work on such an obese person and that they would perform CPR only if he lost 200 pounds. The team knows that Mr. Lomond will arrest long before his weight decreases. Critical Thinking Questions for Case 5 • Apply Beneficence and PPM to this case. How would you classify Jimmy’s clinical condition? What ends of medicine are available for this patient, and how do those ends define what counts as benefitting vs. harming him? Are interventions futile or burdensome? • Given your previous answers, are physicians morally required to offer CPR and keep Jimmy a full code? Put otherwise: is it morally acceptable to write a DNR order without the permission of the patient or patient surrogate? • Would withholding CPR from Jimmy count as euthanasia? • Given Mrs. Lamont’s disagreement with the healthcare team, do you think they are right to deceive her?