Laura Penman works in a nursing home with a specialty in dementia care. She floats from the units that provide care to patients with mild dementia to the locked floor for those with severe end stages...

Laura Penman works in a nursing home with a specialty in dementia care. She floats from the units that provide care to patients with mild dementia to the locked floor for those with severe end stages of the disease. Today she is assigned to care for Sandra McKendrick. Sandra is an 82-year-old woman with end-stage Alzheimer’s disease. Laura remembers her from when she was admitted to the facility several years ago. Last month, Sandra’s daughter Kate agreed to placement of a feeding tube to get her mom through an acute hospitalization for flu-related pneumonia. She completed her course of intravenous (IV) antibiotics, but her cognitive and self-care (particularly feeding and eating abilities) abilities have not improved. Kate is visiting tonight and says “I don’t know what to do for my mom. I wish I never agreed to the tube. She is not better, but if I ask the doctors to take it out now, my sister says I will be inhumane because my mom will starve. I don’t know why my mom picked me as her health care proxy. This whole situation stinks!” How would you respond to Kate’s statement? Is it ethical for the family to withdraw the feeding tube? What would you say to Kate’s sister during this difficult situation?