The uncustomary quiet of a Sunday morning in the emergency department is broken by a universally relevant question.

“And if your heart were to suddenly stop beating, what would you like us to do?”

Standing outside, all I hear is a garbled response.

“That’s right,” the voice reassures. “You wouldn’t want us jumping on your chest, would you?”

It seems to me that the doctor is having a one-way conversation, the kind I am about to have with my patient.

Following a bad fall months ago, my patient can’t speak or move. I wonder what “further functional decline” could possibly entail but her nursing home has sent her to emergency. She has pneumonia and a high sodium level not compatible with life. Yet, when I stand next to her and take her hand in mine, she smiles at me, displaying not an iota of distress.

The mild pneumonia might not take her life, but the untreated sodium level almost certainly will. What to do? Antibiotics and fluids or not?

“What would you like me to do?” I muse, hoping she will magically answer.

She smiles benignly. I am torn.

The doctor in the adjoining cubicle clearly doesn’t want her patient undergoing CPR. I can’t see how “saving” my own patient from death would accord her better quality of life. Each doctor is making an irrevocable decision about a patient, its enormity compounded by the fact that both patients have limited capacity to participate in the conversation.

But what if the patient asked, “Doctor, if you were in my situation, what would you do?”

Do doctors treat patients in the........

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