DNR
For the elderly or ill, a DNR order can help ensure death with dignity - Shae Irving JD
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image by: Frank DiBona
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Don’t want ‘heroic measures’ as part of your end-of-life care? Have the conversation
For one month this spring, my job as a senior resident in a large teaching hospital entailed racing around the hospital, managing patients who had rapidly become sicker; I wore running shoes every day. I also led every code, orchestrating a team of doctors, nurses, respiratory therapists, and pharmacists in an effort to resuscitate patients after their hearts had stopped. Some of the very sick patients under my care had do-not-resuscitate orders, but most didn’t. For them, my team and I provided whatever treatments we could.
One night, a colleague asked me to see Mr. S, a middle-aged patient with worrisome vital signs.
Arriving at his bedside, my colleague, Dave, and I…
Resources
Is offering 'futile resuscitations' really the right thing to do?
CPR was invented to restart the heart following specific heart-rhythm abnormalities, and was very effective in doing so. Since then, its scope has been expanded to become the default for anyone whose heart stops, despite the fact that its efficacy is extremely limited in most medical conditions. CPR is ineffective in many patients, as it does not correct the underlying conditions that caused death, such as cancer.
When Is a Do Not Resuscitate Order the Right Choice?
Sometime a "natural death" is the best option for everyone.
An Advance Directive Type That’s Hard to Misplace
The DNR tattoo is a perfect solution. I call on Congress to enact legislation to make this option available all over America so patients don’t have to worry whether their health-care wishes will be respected or not. Once the medical staff sees the DNR tattoo, it has a clear and legitimate restraining order for any resuscitation attempt.
D.N.R. by Another Name
The key question: Should your parent have a D.N.R. order, meaning “do not resuscitate”? Before you answer, another key question: Would that decision be any clearer, easier or less painful if the order was instead called A.N.D., for “allow natural death”?
People With Do-Not-Resuscitate Orders Nearly 3 Times as Likely to Die After Surgery
A new study published in the Archives of Surgery, most likely the first of its kind, suggests that patients with do-not-resuscitate (DNR) orders are significantly more likely than other patients to die soon after surgical procedures. Part of the explanation is that people with DNR orders are more likely to have serious or life-threatening medical conditions in the first place—but a second possibility is that surgeons don't treat DNR patients as well or as aggressively as other patients.
Protecting Herself From Hero Doctors
Getting a Do Not Resuscitate tattoo on one's chest is a threat I've heard made many times by fellow health care workers.
What to Do When a Patient Has a 'Do Not Resuscitate' Tattoo
We’ve always joked about this, but holy crap, this man actually did it...
When a parent directs a child not be resuscitated, what should educators do?
The common factor is happy, healthy and engaged children. As educators, we make and sustain these places. Our codes of ethics place students’ interests at the core of our professional service. We act “in loco parentis” – in the place of a parent. But what happens when we receive a medical directive that requires that we do not resuscitate one of our students? Do we allow students whose parents have given a directive saying “Do Not Attempt Resuscitation” (DNAR) to die at school? How do we reconcile this ethical dilemma of serving the best interests of our students when they face impending death?
When Doctors Ignore ‘Do Not Resuscitate’ Orders
Over 88 percent of physicians don’t want to be kept alive in a situation where doing so only prolongs their existence. So why aren’t they listening to patients who ask for the same?
Don’t want ‘heroic measures’ as part of your end-of-life care? Have the conversation
There’s no doubt heroic measures save some lives — but they aren’t what everyone wants. That’s why end-of-life discussions are essential for protecting patients and empowering them to make clear, well-informed decisions that let doctors do right by them. It’s absolutely vital that we keep these conversations going.
Do Not Resuscitate (DNR) and POLST
The POLST and DNR are medical orders for individuals in ill health, whereas the advance directive can be created by any decisionally capable adult to express wishes regarding preferences in treatment at the end of life or in response to possible health events.
NOLO
Typically, people consider a DNR if they have a terminal illness or are at a high risk for cardiac or respiratory arrest. In the words of the Texas law authorizing DNR orders, the document serves allow a person “to forgo resuscitation attempts and … have a natural death with peace and dignity.” You can revoke a DNR order at any time.
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