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A patient's death prompts a doctor to assess 'Do Not Resuscitate' orders
The Washington Post ^ | March 9, 2010 | Boris Veysman, M.D.

Posted on 03/09/2010 8:37:48 AM PST by walford

...The papers clearly show that both CPR and intubation should have been off-limits. I didn't know this, and I erroneously saved my patient's life.

I carefully explain that everything happened fast. We weren't aware of the DNR and the DNI. Now, he's stabilizing. Then I get the story: several failed rounds of chemo; several weeks of weakness, decreased appetite and depression; many days of feeling unwell. I hear that his meds don't include appetite stimulants, antidepressants or narcotics; why not? The family wants me to "make him comfortable."

"Right now he's comfortable," I respond, and they appear surprised...

(Excerpt) Read more at washingtonpost.com ...


TOPICS: Culture/Society; Extended News
KEYWORDS: death; life; medicine
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Then the family, wearied by the medical interventions -- and the apparently erroneous advice that the patient had no chance of surviving with "quality of life" -- decided to deny treatment and allow him to expire.

The doctor erred on the side of life and the family erred on the side of death. Which direction are we headed now? What future are we choosing as a result?

1 posted on 03/09/2010 8:37:49 AM PST by walford
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To: walford

There’s no link?


2 posted on 03/09/2010 8:40:29 AM PST by DJ MacWoW (Make yourselves sheep and the wolves will eat you. Ben Franklin)
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To: walford

Life at all costs then?

I have a relative who went into the hospital after a home delivery. She had a staph infection. They have removed most of the lower organs, amputated all limbs, and she is still in dire condition.

While the story you quote is great, at what point do you pull th eplug and say enough is enough?

Life is not worth saving at some point. People need to get over the life at all costs because the survivor may not have enough left to warrant it.

Let the kids remember mom as a whole being not chopped into little pieces just because we want to preserve her ‘life’. There is a balance here and oftentimes I wonder if the pro-life crowd even understands this or is willing to acknowledge the issue.


3 posted on 03/09/2010 8:46:01 AM PST by wireplay
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To: walford

the docs have been wanting to DNR my wife for about a month. I’ve been refusing, fighting a losing battle as her chances wane.

then over the weekend, she begain to respond. not much, just a nod of the head now and again, but something. now they understand.

I asked her whether she was glad to be alive - BIG nod.


4 posted on 03/09/2010 8:48:58 AM PST by camle (keep an open mind and someone will fill it full of something for you)
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To: wireplay

And they used to say “God is dead.” I’m SO glad you’ve elected yourself to that position. Please provide a mailing address so we can all properly provide our tithes.


5 posted on 03/09/2010 8:51:56 AM PST by Pecos
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To: DJ MacWoW

Different title but perhaps this is the link.

http://www.washingtonpost.com/wp-dyn/content/article/2010/03/08/AR2010030802432.html


6 posted on 03/09/2010 8:53:57 AM PST by bgill (The framers of the US Constitution established an entire federal government in 18 pages.)
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To: bgill

Yea, that’s the one. The title was different in the print edition, but the text seems to be the same. Fascinating reading. I recommend reading the entire piece.


7 posted on 03/09/2010 8:59:54 AM PST by walford (http://the-big-pic.org)
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To: camle

Indeed, note what else the doctor said:

“...In my role as a doctor, I’ve met countless disabled, disfigured, machine-supported people who enjoy living and wish to continue doing so as long as possible. I’ve met intensive-care survivors who lead full, productive lives, often with few or no memories of their ordeals and heroic procedures because their sedation was done correctly. So here are my educated instructions.

I refuse to have a DNR or DNI order for myself. Go ahead, doctor and family, give me some comfort meds, then shock me, tube me and line me.

Life is precious and irreplaceable. Even severe incurable illness can often be temporarily fixed, moderated or controlled, and most discomfort can be made tolerable or even pleasant with simple drugs. In chess, to resign is to give up the game with pieces and options remaining. My version of DNR is “Do Not Resign.” Don’t give up on me if I can still think, communicate, create and enjoy life. When taking care of me, take care of yourself as well, to make sure you don’t burn out by the time I need your optimism the most...”


8 posted on 03/09/2010 9:03:20 AM PST by walford (http://the-big-pic.org)
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To: camle

Glad to hear things are improving some...!!


9 posted on 03/09/2010 9:05:37 AM PST by Osage Orange (A fear of weapons is a sign of retarded sexual and emotional maturity. - Sigmund Freud)
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To: walford; bgill

That was very good. Thanks!


10 posted on 03/09/2010 9:13:14 AM PST by DJ MacWoW (Make yourselves sheep and the wolves will eat you. Ben Franklin)
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To: walford

The physician didn’t err; he had no choice but to aggressively resuscitate. Thanks to the malpractice lawyers, even if a family is waving 4 DNR’s the team has to do all it can to keep the patient alive. After all, the patent’s long lost aunt might show up and sue!

This family put the ER in a no win situation. If they (and the patient) truly wanted no heroics at all, the patient should have been signed in to hospice. When a family starts listing what can and can’t be done, no one can blame the doctor for doing everything. I’ve seen too many families think they want no heroics, only to change their minds when the patient arrests.


11 posted on 03/09/2010 9:28:12 AM PST by Mangia E Statti Zitto
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To: Pecos

I take it you have never had to face pulling the plug on someone?

Is death something you have never had to face up close and personal or have you immunized yourself from it somehow?

Is keeping a respirator going when there is nothing but a beating heart compassionate, cruel, selfish?


12 posted on 03/09/2010 9:35:47 AM PST by wireplay
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To: Mangia E Statti Zitto
Thanks to the malpractice lawyers, even if a family is waving 4 DNR’s the team has to do all it can to keep the patient alive.

Not in my experience. In this case the DNR documentation was not immediately available to the code team. Therefore, they were obligated to do a full code. However, if the documentation was available, they would not have acted. This happens in virtually every hospital, everyday.

13 posted on 03/09/2010 9:40:46 AM PST by outofstyle (Resistance to tyrants is obedience to God)
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To: wireplay
"Let the kids remember mom as a whole being not chopped into little pieces just because we want to preserve her ‘life’. There is a balance here and oftentimes I wonder if the pro-life crowd even understands this or is willing to acknowledge the issue."

Have you ever heard of Nick Vujicic? Put that name into your search engine and read about him, or go to youtube.com and see videos of him.

The mom of these children is a whole being living inside a body that has been chopped in various ways. She can't hold her children in her arms, but her children can certainly hug their mom. She is a person. She still is their mom. She is alive. It isn't our place to write someone off because of their impairments.

Decisions about life should be in God's hands. We should put our trust in Him.

14 posted on 03/09/2010 9:59:07 AM PST by LucyJo
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To: camle

I’ll pray for you both.


15 posted on 03/09/2010 10:00:04 AM PST by Bookwoman ("...and I am unanimous in this..")
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To: Bookwoman

thank you. you’re kind


16 posted on 03/09/2010 10:05:20 AM PST by camle (keep an open mind and someone will fill it full of something for you)
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To: walford

Make out a “WILL TO LIVE”! NOT a Living Will

http://www.nrlc.org/euthanasia/willtolive/index.html


17 posted on 03/09/2010 10:10:20 AM PST by maine-iac7
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To: camle

congrats on the improvement. stay strong and do not let anyone tell you to give up hope.
my mother passed away just before christmas. she chose dnr and was a hospice patient. she was doing okay until the day before she went. the day of, she was mostly unresponsive. my brother suggested to the nurse that perhaps an iv would help her but the nurse said that it would not improve her status much if at all. i told my brother we couldn’t do it anyway because she would not have wanted it, she was ready to leave. if she wasn’t ready she would not have gone. she left about an hour later.
i truly believe that when the one doing the dying is ready to go they will go no matter what the people who love them would prefer.


18 posted on 03/09/2010 10:27:45 AM PST by madamemayhem (defeat isn't getting knocked down, it's not getting back up)
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To: madamemayhem

i figure that if the Big Guy want’s them, who am I to argue? I always pray for “thy will be done”, not my will. but sometimes it seems like it take a while for him to make up his mind...


19 posted on 03/09/2010 10:40:38 AM PST by camle (keep an open mind and someone will fill it full of something for you)
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To: maine-iac7

Thanks for the link. Very helpful.


20 posted on 03/09/2010 10:55:23 AM PST by walford (http://the-big-pic.org)
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