ABSTRACT
A 78-year-old married woman with progressive Alzheimer's disease was admitted to a local hospital with pneumonia and other medical problems. She was able to recognize no one, and she had been incon tinent for about a year. Despite aggressive treatment, the pneumonia failed to resolve, and it seemed increasingly likely that this admission was to be for terminal care. The patient's husband (who had been tak ing care of her in their home) began requesting that the doctors be less aggressive in their treatment and, as the days wore on, he became more and more insistent that they scale back their aggressive care. The physicians were reluctant to do so, due to the small but real chance that the patient could survive to discharge. The husband was the patient's only remaining family, so he was the logical proxy deci sion maker. Multiple conferences ensued; finally a conference with a social worker revealed that the husband had recently proposed mar riage to the couple's housekeeper, and she had accepted.
