Overview; I. Scenario History of Present Problem: Joyce Johnson is a 58-year-old woman with a history of atrial fibrillation, COPD, and depression.

Joyce Johnson, 58 years old Overview When a patient has a stroke, is intubated, and unable to wean off the ventilator, what can be done to ensure the patient’s autonomy when there is no living will and no family that can be contacted to guide this decision-making process of a vulnerable adult? Remain Intubated or Withdraw Life Support I. Scenario History of Present Problem: Joyce Johnson is a 58-year-old woman with a history of atrial fibrillation, COPD, and depression. A friend who had not heard from her for two days became concerned and went to her home. She found Joyce unresponsive on the floor of her living room. She had a large left middle cerebral artery (MCA) ischemic stroke. She is intubated and has remained in ICU since she was admitted to the hospital five days ago. She is also in acute renal failure as a result of rhabdomyolosis and requires daily dialysis. Personal/Social History: Joyce is divorced, and has one adult daughter. She is estranged from her siblings and has not spoken to her daughter in five years. She is on disability for severe depression. Depending on how she feels, Joyce inconsistently takes scheduled medications including warfarin