Abstract

A commentary on a case of a man who is left a “high quad” (ventilator dependant as well as quadriplegic) after an accident discusses the following: • The right of patients who sustain catastrophic injuries to choose to discontinue life-sustaining treatment• The role of capacity assessment in treatment decisions and in ethics consultations• The role of advance directives (ADs) for such patients if they lack capacity• Whether a do-not-resuscitate or do-not-attempt-resuscitation order should be seen as “a medical order” or an advance directive• Some hints about what might be intended when a patient refers to the criterion of having a “meaningful life.”