This week we learned that advance directives are not an exact science. For the following hypothetical, step into the shoes of the physician and discuss what course of action you would take, and what the law would likely require of you.

Jake Singleton was a 35-year-old healthy male with a wife, Susan and two small boys, Jake Jr. and Matthew. When Susan and Jake first got married, before they had kids, at the recommendation of his financial advisor, Jake drew up and executed a living will. As part of that living will, he explicitly stated that he did not want "to be a vegetable and have his family cry over him." Thus, he wrote that he could be on a ventilator for no longer than one month. He appointed his wife of 10 years, who was his high school sweetheart, as health care power of attorney/proxy in the event he was not able to make his own decisions.

Sadly, Jake gets into a severe car accident on the way home from work one day and is rushed to the hospital, where you, Dr. Student, are assigned as this primary caregiver. After assessment, diagnoses and admission to the hospital, it is determined that John incurred severe brain trauma and may never wake up. Dr. Paul, a neurosurgeon in the hospital has stated that he has seen numerous patients wake up from this specific injury, but all have taken two to three months to do so. All of this is told to Susan, Jake's wife.

Susan is fragile and frantic from the events and trying to manage their two sons. She tells you that there is NO way Jake would want to be pulled so quickly from the ventilator if he knew that other patients woke up after a few months. Also, he would not want to leave his boys so early in life. She pleads for you to ignore the very specific living will and keep the ventilator in after one month. Meanwhile, Jake's parents tell you that, as painful as it is, Jake was steadfast and firm in his choice to not be on a ventilator after a month.