During her third week in the nursing home, Marion develops a cough, high temperature, and respiratory problems. She is hospitalized with a diagnosis of pneumonia. Marion immediately becomes disoriented and attempts to remove her intravenous and oxygen tubing. Since she tries to climb out of bed, her daughters must remain at her side. The attending physician tells the daughters that in addition to treatment for pneumonia, Marion will also need to have a pacemaker inserted to regulate her heartbeat. However, Marion would then be unable to return to the nursing home, since the facility is not equipped to care for someone recovering from surgery.
After thoughtful discussions with other family members, Marion’s daughters tell the physician that they do not want to put their confused mother through the surgical