Do Not Resusitate - a "death penalty?"

[Bri w]

Not wishing to derail the excellent Death Penalty Poll/thread.

In Sept '08 my mother-in-law(aged 82) was taken into hospital, and whilst in A&E had a respiritory attack. Resusitated, transferred to HDU and ventilated. In discussion with the Consultant, immediately after resus, he asked us to consider applying DNR to her file - to ill to go thro' another resus, brain damage due to lack of oxygen, quality of life, very unlikely to see the night out, will need permanent care if she survives.

4mths later she was released home. Today, although a lot stronger she's not exactly in good health, she has oxygen at home, and has nurses visiting 3 times a day. Mentally she isn't quite there but is more than capable of making conversation on most topics. However, her judgement is a bit off the scale, e.g. if you rang her and offered to sell her an ice berg she'd give you her bank details.

She enjoys the visits from her children, grandchildren and friends. TV is another pleasure, as is her weekly, supported, trip arounds Tesco's.

Even though she is enjoying a 'limited' life she is still, after several requests, DNR. Because we originally said yes to DNR, in the circumstances 16mths ago, the Consultant now refuses to remove it from her file.

Doctors have no right to decide who lives or who dies.

Screw 'em.

Get some legal advice, I would say its unlikly that he is within his rights.
But Iam just an idiot on an internet forum, this could be a life or death matter so get some proper advice.

[anna]

http://www.wvoems.org/media/20890/dnr_act.pdf

The above is Artical 30C of the DNR act I think section 16-30-c8 is the one you are looking for.

Blasted DNR. Loada balls IMO. Hope your mother in law improves, and doesn't need resus. Perhaps before taking legal action you could try and see if you could see some one else. Perhaps visit your GP (they can't do squat), but if your GP is nice they may refer you to another Consultant of said specialty, whose opinion may differ. Also, is she with Bupa?

Originally Posted by The Basket

Doctors have no right to decide who lives or who dies.

Screw 'em.

Not entirely true. If you have somebody on a life support machine who simply has no chance of recovery, then doctors have the responsibility to ensure other patients who need that machine are able to do so. Not everything is black and white, and Doctors are given limited resources to work with.

I'm not talking about patients who 'may' recover but inevitable certainties. Lets suppose a child with severe (but recoverable) epilepsy becomes comatosed and is denied life machine support due to lack of resources (another patient being kept alive for 3 weeks on life support). If that child then dies, or becomes more disabled than they should be, and it is later found that a medically unrecoverable patient was using up valuable resources, the Doc would be facing a much more significant moral dilemna.

Harsh, but such is the reality of the finite resources we have. This is where I believe a Doctor has the right to 'end' a life. (We're not talking euthanasia here people btw!).

[Richie]

nice work Anna, I think thats what Bri needs to know.

The consultant cannot refuse to remove the DNR Bri. An oral request is usually sufficient but in this case i`d follow it up with a written request.

Originally Posted by thulfi

Not entirely true. If you have somebody on a life support machine who simply has no chance of recovery, then doctors have the responsibility to ensure other patients who need that machine are able to do so. Not everything is black and white, and Doctors are given limited resources to work with.

I'm not talking about patients who 'may' recover but inevitable certainties. Lets suppose a child with severe (but recoverable) epilepsy becomes comatosed and is denied life machine support due to lack of resources (another patient being kept alive for 3 weeks on life support). If that child then dies, or becomes more disabled than they should be, and it is later found that a medically unrecoverable patient was using up valuable resources, the Doc would be facing a much more significant moral dilemna.

Harsh, but such is the reality of the finite resources we have. This is where I believe a Doctor has the right to 'end' a life. (We're not talking euthanasia here people btw!).

A doctor can kill a patient to free a bed? That would solve the waiting list problem.

[Bri w]

Thanks Anna, just what we needed.

Thulfi, I've worked in the acute care areas for the last 18 years, as a biomedical engineer, and have overheard many conversations about withdrawing support and making comfortable. And even a Senior Consultant bo££ocking a Junior for 'bed blocking' with a hopeless case.

June '09 saw my two sisters and I having to make the decision to withdraw support and make comfortable for our Mum... harsh and sad times.

The DNR applied to the mother-in-law is, imho, now wrong but we are not naive or blinkered in making that decision. Equally I know how harsh and painful resus can be and any decision made would be in M-I-L's best interests, not our own (selfish) keep alive at all costs.

Originally Posted by The Basket

A doctor can kill a patient to free a bed? That would solve the waiting list problem.

Not really to solve waiting list problems. More to free valuable finite and expensive resources that can be used to save somebody that actually has a chance.

ie

Originally Posted by Bri w

Thulfi, I've worked in the acute care areas for the last 18 years, as a biomedical engineer, and have overheard many conversations about withdrawing support and making comfortable. And even a Senior Consultant bo££ocking a Junior for 'bed blocking' with a hopeless case.

Hope everything works out comfortably for you and the family Bri. This is very well said...

Originally Posted by Bri w

Equally I know how harsh and painful resus can be and any decision made would be in M-I-L's best interests, not our own (selfish) keep alive at all costs.