Does Depression Affect Decision-Making Capacity in End-of-Life Issues?
Case Presentation Mr. K is a 58-year-old Caucasian male with a long-standing history of diabetes mellitus, hypertension, and chronic kidney disease who has been on continuous ambulatory peritoneal dialysis for 3 years. Initially, treatment achieved good adequacy of dialysis, and the patient reported a feeling of well-being. During the last 6 months, however, his dissatisfaction with dialysis increased, which he attributed to the increased time needed to perform exchanges and his weight gain. Mr. K underwent right lower-extremity, below-knee amputation secondary to gangrenous foot as a complication of severe peripheral vascular disease. The postoperative course was complicated by symptomatic gallstone disease and acute cholangitis requiring laparoscopic cholecystectomy. After the abdominal surgery, the patient underwent temporary hemodialysis. It was felt that Mr. K could benefit from a comprehensive rehabilitation program to maximize functional independence prior to his return home. He
