Refusal of food and water by a man with end stage Parkinson's disease.

In the future, we need to consider the social and financial implications of allowing someone to remain in an acute care hospital for comfort care until death. Other acceptable options for the non-terminal but, severely disabled patients must be identified so that we are able to respect and honor our patients' autonomous decisions without using the increasingly scarce health care resources. While not all ethical dilemmas of this nature will be resolved in such a relatively uncomplicated manner, this situation does provide us with a foundation from which to approach future cases. We have learned to listen closely to our patients; we have learned the importance of understanding who our patients were and who they are now; we have learned from Mr. K's strength to express his convictions.