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nurses, and social workers all gathered in the Ward 6B
conference room, and discussed about end-of-life care in peace;
the patient and his whole family understood what was
discussed; and the meeting record was documented and signed
by all medical staff and some of the patient’s family members.

A few days later, the patient decided not to sign the
end-of-life document and the DNR agreement because he was
worried that the medical staff would give up on him. The
medical staff expressed understanding to his concern and
assured that “the comprehensive medical care will be continued,
but no CPCR would be done at the last moment, as we consider
that the ending of his life inevitable regardless of what we do”.
The patient was not asked to sign the documents again and all
routine medical care to treat his heart failure and ischemic
cardiac allograft continued.

Mr.X then quitted smoking and rehabilitated himself with
the aid of the cardiac rehabilitation team. He was eventually
discharged from our hospital, and has been followed up at
cardiac outpatient service in a stable condition.

We, as a medical team, failed to predict the patient’s death
and life span. In such a patient with cardiac allograft
vasculopathy, which is a non-cancer chronic disease, medical
professionals usually feel difficult to assess the patient’s

26 107 年度•醫學倫理•人文醫學•心得