Fourth week...already?!

My mystery man passed away.
What did he die of? I don't know.
Will we ever find out? No.
Why? Because he does not fit in the 'unexpected deaths' or the 'within 48 hours of hospital admission' or any other criteria for which a post mortem is required. And although I said that I would not be able to fill out the death certificate as I did not know what to write in it, my senior did, after getting advice from the hospital pathologist and the coroner.
I guess were I the gentleman's relation I would have preferred him not to have a PM - after all - he suffered enough in life. There is no need to do this to the body - and there is no question about mismanagement - its probably just the body saying its had enough.
Sometimes I think we do too much - but it is difficult to know when to stop.
Take for instance a gentleman who has been on the ward for at least a month. He has terminal multiple sclerosis. He cannot swallow safely, and was therefore being fed via a nasogastric tube. Which was doing really well, until earlier this week. His NG tube has had to be replaced twice in the last two weeks - as it keeps coming out due to a combination of him tugging on it and his skin being very sweaty (apparently due to his MS), so no amount of plasters can hold it down. They tried re-inserting a NG a few days ago, but he started gagging - so they stopped. As my consultant is away, no-one else can take the responsibility of withdrawing treatment. Not even the family. And we are not contacting the family, until the consultant gets back - which is in four days time. So until then he will be nutritionally supported by fortified custard, when ever the nurses find the time (which is not very often) and he is being hydrated by intravenous fluids. But his cannula fell out last night, so the nurses resorted to giving him subcutaneous (through the skin) fluids. And as we are giving him fluids, I need to take blood from him ever two days - but as his limbs are bent in all directions due to his contractures and he grimaces every time I touch him, I really hate to take blood from him as I feel I am causing him undue pain. My SHO says that the justification is that we have to make sure that we are giving him what he needs rather than what our gut tells us he needs. I dont know. I think we should talk to his family and decide - either he has an operation, which they previously felt to be too risky, but which should he survive will mean a long term way of feeding; or we withdraw care completely.
Unfortunately both options are difficult.
Thank goodness I'm only a PRHO.