We are aware of the following facts in Katherine's case:

1.Katherine is in a comatose state. After arresting several times, she remained comatose and presumably irreversibly unconscious. After other complications, her state progressed to slow multisystem failure. She was beyond the capability of experiencing the burden of pain by her vegetative state

2.Katherine had not made it clear by written directives nor communicated any specific instructions to her family (evident by the fact they are in disagreement) about withdrawing life-sustaining treatments if she ever became irreversibly unconscious and lost decision-making capacity.

3.The proxy, in this case the family, must rely on the reasonable treatment standard because Katherine's wishes were never clearly communicated. Following the third resuscitation and development of multisystem failure, the family disagreed on further treatment determinations. The consultation committee clarified options, but indecisiveness persisted. Agreement was eventually reached.

4.Proxy decisions regarding life-sustaining treatments were as follows:

a. After second resuscitation and comato

2.Life is good, yet not for Katherine because her multisystem failure and comatose state effectively prevent her from experiencing life and being aware of life.

It is important to point out that the family is not making a choice between one ethical and one unethical option, rather two ethically reasonable options. If an older patient is comatose with multisystem failure and vegetative existence, it is difficult to see how moral reasons could justify prolonging her life. However, continuing such treatment is not immoral. From an ethical perspective, it may be argued that continuing with treatment causes no harm to her. However, she is experiencing no benefit from the treatment. The costs of providing treatment with no benefit to the patient is unreasonable. The ethics of right reason find nothing to justify the life-sustaining treatment. The case raises the question of the proxy's ability to insist on treatment considered medically inappropriate. In this case, the family isn't totally adamant on the continuation of the treatment. There is no sign that a suggestion or opposition by the doctor would cause extreme controversy. Perhaps reasonable members would be able to help the others see it this way. The doctor is obligated, especially following the decisions after paralysis, to offer the more reasonable ethical option.

c. Development of paralysis of the gut: continue feeding

From the provider's perspective, Katherine's family really has no idea what her intentions are. She is slowly dying in an unconscious state and her family has refused invasive treatment for her systematic problems yet supports the sustainment of her life. If the pr

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