DO-NOT-RESUSCITATE ORDERS
The following is two pages from Your
Last
Year:
Creating Your Own Advance Directive for Medical Care.
Some 'check-list' Advance Directives merely ask
whether or not you approve of DNR orders for yourself.
And some people have checked "Do Not Resiscitate"
without thinking deeply about what this might mean.
The following selection encourages us
to avoid any blanket rejection of resuscitation.
If you wish to quote anything below,
the page numbers appear at the bottom of the pages.
Full bibliographic information will be found here: Your
Last Year.
A. Avoid Blanket Do-Not-Resuscitate Orders.
Blanket DNR orders state that you never want to be
resuscitated.
This is an
extremely unwise
decision,
unless you have
already decided to die at the next good opportunity.
So do not state in
your Advance Directive that you never want CPR.
Traffic accidents
or plane crashes are obvious examples
of situations in
which a blanket DNR would be foolish.
Whenever first-aid
will keep you from dying, you want
treatment.
124
YOUR LAST YEAR: CREATING YOUR ADVANCE DIRECTIVE FOR MEDICAL CARE
When your death is caused by something
completely unexpected,
you would normally
want everything done to stabilize your body
so that further
evaluation could be done.
If then there is
little hope of returning to your normal life,
you can be
disconnected from all life-supports and allowed to die.
If you had a blanket DNR order, which was strictly enforced,
then the emergency
team would be instructed
not to do anything
for you at the scene of the crash.
They would just go
on to other victims and let you die on the spot.
If you only had a
few weeks to live anyway
(perhaps because
you were dying of cancer),
then a blanket DNR
order would make sense.
Such reasons for a
blanket DNR order would be easy to explain.
And if you are dying, you should also consider an at-home DNR,
which means that
if you die at home, those around you
should not call
911 to summon the emergency medical team.
If you have already decided against all further hospitalizations,
then you might
welcome a sudden and
unexpected end to your life,
as might come in
the form of a stroke or heart attack.
If this is your
wish, you should certainly discuss it
with those who
might be tempted to call 911 if you die at home.
If your body gives
out in the hospital,
the nurses already
know they should not
call the 'crash cart'
(the machinery
needed to restart your body)
because your DNR
order is well documented and accepted by all.
In answering this Question for your Advance Directive,
you should imagine
all possible situations that might apply to you.
The fact that you
have considered these matters in advance
—when you can be
more rational than in emergency situations—
will give much
more weight to your decisions about
just when you
should be resuscitated
and when you should not.
In some emergency situations, prior DNR decisions are unknown.
Some people have
suggested a bracelet
proving your DNR status.
This would inform
the emergency medical team not to resuscitate you
if they are called
by strangers who have no knowledge of your wishes.
The emergency
medical team and/or emergency-room personnel,
will proceed on
the assumption that you want to be saved from death
—until they
receive definite information to the contrary.
If and when they
are informed of your documented wishes
not to be
resuscitated, they will cease their efforts to save you from death.
QUESTION
13:
DO-NOT-RESUSCITATE
ORDERS by JAMES
PARK 125
For non-emergency situations, such as lying in
a hospital bed,
you might decide
that a DNR order should never be written for you.
This will mean
that every time your body fails,
the 'crash cart'
will be called
and the doctors
and nurses then on call for resuscitation
will rush to your
bedside and do their best to prevent you from dying.
Or you might decide in light of a poor prognosis,
giving you a short
life-span in any case,
that you would
prefer no attempts to
save you from death
if your heart
and/or lungs stop working.
Whatever you decide about resuscitation,
your decision will
be easier for others to accept and carry out
if you also
explain your reasons
for making that choice.
The selection above is two pages from
Your
Last
Year: Creating Your Own Advance Directive for Medical Care.
If you click this title, you will see
the complete table of contents.
The following sections of this book
discuss
specific situations
in which you would want
to be resuscitated
and some situations in which you
would not want to be resuscitated.