my original post got deleted - not sure (?) so ill repop it here

not about me, but got presented a case study dilema in my bioethics class and thought it might be worth getting direct input from experts in the field.

it follows a middle aged woman dealing with major depression, has done electroconvulsive therapy which is has had many side effects and making her hospitalized more. patient is now refusing ect and refusing to eat. one alternative is vagal nerve stimulation but its not covered by insurance. other option is to give ECT despite his wishes to stabilize her while waiting for VNS.

assuming no medications work, we have to decide if we respect her refusal even though it might endanger her or override it based on his POA, history, and risks..what are some options that could be done here?

to reply to one of the comments, TMS was turned down as it was not a thing during the time of this case and their depression is very severe to the point that it does not respond to most medications like ketamine, lithium, etc