Mr. Z is 86-years-old, Caucasian male that lives with his wife of 56 years. He values his independence, but recently he been struggling to care for himself. He has a long-standing history of diabetes mellitus, hypertension, and chronic kidney disease. His wife was concerned because she noticed her husband can no longer drive, is having difficulty walking, and managing his own care and daily medication. She explained that her husband is lethargic, sleepless, having poor appetite and difficulty maintaining his weight. After his doctor noted that Mr. Z has lost interest in the things he used to enjoy, he was diagnosed with depression. It was also noted that Mr. Z expressed feelings of killing himself with a gun. However, after discussion with his doctor, Mr. Z agrees to try anti depressant medication to help with the mood disorder. A week after the medication is started, before the effect of the medication can be seen, Mr. Z is admitted to the hospital for a heart attack. His heart is so damaged it is having difficulty pumping blood to keep his kidneys functioning …show more content…
56-57). In Mr. Z’s case, these principles are in conflict. Mr. Z’s prognosis is unclear, and the physician is not clear if the benefits of dialysis will outweigh the burdens. Under normal circumstances, Mr. Z would have the right to make the decision to refuse dialysis treatment. However, his physician questions Mr. Z’s capacity for autonomous decision-making is impaired by depression. From a legal perspective, one must decide if Mr. Z is either competent to make decisions for himself or incompetent to do so, in which case someone else makes decisions on his