“And who are you?” Tracking the voice, I realise the nurse is talking to me.

“I’m the physician looking after the patient.”

I have drawn back the curtains to find my new patient slumped in bed. My hand reaches for her pulse in her neck, wrist or groin but I feel nothing. A nurse says the patient was just speaking, which doubles my consternation.

“No pulse, we need compressions,” she prompts.

In her late-80s, the patient has end-stage kidney disease and other serious conditions. Having consistently refused dialysis, she has identified her priority as spending her remaining days at home with her husband. Wanting only to be kept comfortable in case of an emergency, here she is – unconscious – and by all appearances, comfortable.

Suddenly, the room is teeming with people and a crash cart. “Wait, she doesn’t want to be resuscitated,” I exclaim.

“It’s not in her notes,” says the nurse, hands primed over sternum.

Apparently, the overnight junior doctor was not convinced the patient meant what she said and had left the morning team to revisit the issue, not expecting the patient to crash. To many readers, this will seem like a material overriding of autonomy but suffice to say this kind of back and forth is all too common in hospitals.

I rapidly summarise the patient’s situation to the gathered crowd and........

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