Article: The tracheostomy tube. (right to refuse treatment)(includes commentaries)

Joe, eighteen years old and unmarried, sustained a severe spinal cord injury in a motor vehicle accident. His arms and legs were paralyzed. He initially required mechanical ventilation, and later a tracheostomy. Three months after his injury Joe was transferred to a spinal cord unit several states away for his rehabilitative care.

Joe was eventually able to be weaned from the ventilator, but his pulmonary status remained shaky. He had an ineffective cough and required frequent assistance and suctioning to manage his secretions. Goals for his rehabilitation included educating him about his body so he could direct his care (range of motion, bowel and bladder care, ...

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