A 77-year-old man whose medical history includes treated hypertension and hypercholesterolemia, previous heavy alcohol intake, and mild cognitive impairment required 15 days of treatment in the ICU for septic shock due to faecal peritonitis from a perforated sigmoid colon.
After being transferred to the surgical floor, he had an unwitnessed fall from his bed suffering an acute subdural haematoma with underlying hemorrhagic contusion, for which her underwent a craniotomy for evacuation of the haematoma. Twelve days after this procedure, during which he received no sedative medications, he remains in a coma with a best motor response of abnormal flexion on the left side. He is still receiving mechanical ventilation. The consensus opinion of treating clinicians is that he will most likely not make a functional recovery.
How should further decisions regarding ongoing management be made?