Bioethicist

8:15 AM — The request comes in.
A nurse calls about a patient who wants to leave before her treatment is finished. The medical team recommends two more days of IV medicine and monitoring. The patient has packed her bag.

9:00 AM — The chart only tells part of the story.
I review the medical facts and ask the physician what could happen if she leaves.

Then I meet the patient, who understands the risk – and has named her IV pole Ivy after three days together. She explains that she is the main caregiver for her father, who cannot safely stay alone. A neighbor is helping for now, but has to leave tonight.

Six pages of medical notes. No mention of that.

10:15 AM — I reframe the question.
The team has been asking, “How do we convince her to stay?” Staying could protect her health, but it could also leave her father without care.

So I ask, “How can we reduce both risks?”

11:30 AM — I bring the patient, physician, and case manager together.
I guide the conversation so everyone has a chance to share their concerns. Together, we look for a way to protect both the patient and her father.

2:00 PM — We have a plan for tonight.
The case manager arranges for someone to stay with her father overnight. The patient agrees to stay at the hospital, while the physician explores treatment options closer to home.

Her bag remains packed. Ivy gets another lap down the hall.

3:15 PM — I document what we agreed to.
The final treatment plan isn’t settled, but the patient’s father will not be alone tonight – and she can make the next decision with all the options in front of her.