Are DNRs Binding?

[Saint_Ann]

When someone obtains a DNR order - which has to be signed off on by the person's doctor - the onus is on that person to take every measure to record that order with their local healthcare systems. Same thing for a living will.

Most people, however, think that their DNR is magically tied to their DNA or SS#.

Most surgical places used to ask at checkin.

 

[HisArpy]

Most surgical places used to ask at checkin.

Now they ask if you've had a fever, cough, or have been around anyone hacking up lung tissue at any time in the last 3 days.

 

[Saint_Ann]

Now they ask if you've had a fever, cough, or have been around anyone hacking up lung tissue at any time in the last 3 days.

As badly as they want to harvest your organs, following a DNR instruction shouldnt be a big problem.

 

[jaF0]

Now they ask if you've had a fever, cough, or have been around anyone hacking up lung tissue at any time in the last 3 days.

I've been hacking and coughing on and off for at least five years.

 

[Counselor706]

A do-not-resuscitate order (DNR) is a legally binding physician’s order stating that no steps will be taken to restart a patient’s heart or restore breathing if the patient experiences cardiac arrest or respiratory arrest. These steps typically involve cardiopulmonary resuscitation (CPR), which is not always successful and comes with risks, especially for individuals who are elderly or very ill. A DNR order may also be called a do-not-attempt-resuscitation (DNAR) order or allow-natural-death (AND) order.

Keep in mind that DNR orders are subject to ethical debate in uncommon yet plausible scenarios. Physicians must often make split-second decisions with huge implications in emergency and surgical scenarios. Regular deep and honest discussions among patients, advocates and physicians are the best method of avoiding undesirable health care outcomes. Social workers, attorneys, mental health professionals, clergy members and other trusted individuals can also provide guidance regarding resuscitation and end-of-life care decisions.

There are infinite contingencies that patients and doctors alike cannot specifically prepare for. Fortunately, another type of valid medical order for advance care planning has grown in popularity over recent years that provides more control for patients and more comprehensive guidance for medical professionals. A physician order for life-sustaining treatment (POLST) form is designed to provide a full set of medical orders that better represents a patient’s overall preferences for their medical care, such as ventilator use and artificial nutrition, rather than just the one decision regarding CPR.

Source

Bonus... POLST Programs: When advance directives aren't enough

 

[jaF0]

One thing I've noticed is that the typical form known as a DNR applies only to field medical responders before they take you in for treatment. It does not apply to hospital staff.

 

[HisArpy]

I've been hacking and coughing on and off for at least five years.

Eww. You should wear a mask or something.

 

[Tigersman]

As a nurse who worked on a medsurg unit, if a patient coded on me and I knew they had a DNR I would not do CPR or call code. I have done CPR and called code on patients without a DNR. Most of these patients either never regained consciousness or if they did, they coded again minutes later and could not be revived. If a doctor goes against a DNR order he risks disciplinary action if a complaint is filed.

 

[dolf]

The stats for ever leaving hospital alive after being resuscitated are pretty damn slim to start with. By the time a DNR is considered, it's almost certain that all you're doing is, at most, slightly prolonging their suffering.

But how much of their training is about dealing with death in a healthy way? I wonder, because most doctors just seem uncomfortable at best, shit scared quite often, and in complete denial at worst.

 

[HisArpy]

The stats for ever leaving hospital alive after being resuscitated are pretty damn slim to start with. By the time a DNR is considered, it's almost certain that all you're doing is, at most, slightly prolonging their suffering.

But how much of their training is about dealing with death in a healthy way? I wonder, because most doctors just seem uncomfortable at best, shit scared quite often, and in complete denial at worst.

Doctors, despite their vaunted skills and degrees and awesome powers to hand out restricted medications willy nilly, are just like the rest of us.



Which should scare the shit out of you after you look around and see how fucked up the world is.

 

[DeYaKen]

Most people dont walk around with a copy in their pocket. Mayo clinic has mine on file tho I probably wont be back there. The med-info "cloud" isnt really in full force as to sharing med history.

In my days of ferrying people to and from hospital I used to carry one lady who carried hers in her handbag and made sure the driver knew she had it. She was eighty three and had lost her husband three years previous. She had a heart problem and during the last stint in hospital had been resuscitated three times despite having a living will which said she didn't want such treatment. The Hospital spokesperson told her that anything other than a DNAR order would be ignored because they couldn't be sure that it was an informed decision.

 

[stickygirl]

I think it's awful that Jafo has raised the issue of cost as being an issue in DNR. JFC as if the trauma of losing someone isn't bad enough. I'm not knocking USA but thank you NHS

 

[jaF0]

I didn't ... exactly. The reference was to be punitive against the providers for ignoring the patient's wish.

But cost is a whole 'nother issue. A single medical event can easily bankrupt a person and their family. A relatively minor hand injury a while back incurred bills of over $10K to my insurance. A heart attack can give your bank account a heart attack, coming in at $100K or more depending on what they do.

I have no idea what a month in ICU for a comatose patient would cost.