The patient's husband is a full-time state employee willing to quit his career to care for his wife. This tragic, morally outrageous case demonstrates many of the ethical dilemmas in high-tech home care. Fewer of us caught the New York Times report this year of Reeve's third-party payer trouble, much the same as our patient's, resolved before that report.
Good ethics needs sound facts.
These are basic questions regarding what is medically possible. They are questions about whether this state is endless, or whether there is an achievable goal in sight, within an understood time period. There are also technical medical questions about competent treatment administration. Unlikely to be technically difficult, for example, home trach care is still a skilled service, with contextual benefits and burdens not yet articulated. We know nothing about preferences or decision-making capacity.