Acute Caremiddle twist
An 81-year-old man had a large left middle cerebral artery infarct ten days ago. He cannot swallow safely and can neither understand nor communicate a decision. The team proposes a percutaneous endoscopic gastrostomy tube on Thursday. Six years ago he completed an advance health directive refusing cardiopulmonary resuscitation and mechanical ventilation; it says nothing about feeding. He has no enduring guardian. His wife, from whom he separated eleven years ago and whom he has not seen since, telephones the ward asking to be consulted. His daughter has lived in his house for six years and visits daily. Which one of the following should the team approach for the treatment decision?