Abstract
After falling from a roof, an older man lost neurological function below his face. In two days, the patient regained consciousness, but it was unclear whether he could communicate his preferences, whether due to injuries or difficulties with language. His family believed he could communicate with them, and that he was capable of making treatment decisions. The staff did not think to contact the hospital’s largely inactive ethics consultation service for assistance, and instead looked to the patient’s living will for guidance, even though the patient was not terminally ill, and his lack of capacity had not been determined.