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Not limited to socialized medicine. I was in the ER with my dad last night and the dr wanted to know about advanced directives. I told him that if dad coded he had to bring him back, or at least try.

The Dr’s response? “Really!?” in a surprised and disapproving tone.

I locked eyes with him and said “Really.”

End of conversation.

This guy was tacky enough to hold this discussion in front of my dad.

grrrrr.

If you only realized the futility of resuscitation efforts. The percentages of recovery are really bad, and those that we CAN save, usually end up brain-damaged and die a short time later anyway.

Full life-support measures are only effective long-term on young, healthy people that have an accident that caused their code.

I share your revulsion as to how this was handled, but the Joint Commission for the Accreditation of Health Care Organizations (JCAHO) actually requires hospitals to question patients and/or their families as to whether or not a living will or advanced directive has been completed and,if so, are the papers on file with the facility. Should have been handled by nursing with the family in a private setting away from the patient.

The slippery slope is coated with ice here already. People like you and others who have disabled loved ones are keen to what is happening and very concerned about the future.

We were in Florida several weeks back. Went to the Kennedy Space Center where it appeared we were the only Americans. The Europeans seemed to be in the majority. Now we are very use to gawkers of all sorts. We choose not to stay home with our profoundly disabled son. Well these folks were different than any other we have ever encountered. Their gawks were also accompanied by looks of disdain. Almost as if we were responsible for ruining their day out. When they had to wait for our son to be boarded on the handicap bus their looks grew to anger and agitation. It was a quick look into their souls and a look into America's future. Currently when out with our son the gawking appears to be curiosity driven with many smiles mixed in. On that long day at KSC there was 1 smile.

Pray for America like you never did before. Do everything in your power to stop this avalanche before it starts. Also, smile at a less fortunate individual as you look at them. If they are alone, praise them for their strength and courage to do life in spite of their many challenges. It will encourage them and also continue to set America apart from the rest of the world.

Unless your dad has been declared incompetent, he should have had the discussion with your dad and not you. Federal (Medicare) law requires the conversation in the hospital - and due to new Medicare law passed this summer, we now have to document similar conversations in our offices. (Remember all the privacy papers you had to sign a couple of years ago?)

Nevertheless, for cardiac arrests in the hospital, approximately 10% (JAMA, 2005 http://jama.ama-assn.org/cgi/reprint/293/3/305 ) survive to discharge. With the new “Continuous” Cardiac Compression guidelines, the number is probably slightly better. In some studies, even out of hospital - the discharge to home rate can be as high as 20%, (http://www.mayoclinic.org/news2008-sct/4704.html )

The people in the hospital are sicker to begin with than the people who arrest out of hospital. An in-hospital arrest is a very good indicator that a lot of organs are not working well, even on maximum medical treatments.

It is reasonable to discuss the chances of recovery, the probability that a person will survive a heart attack or ever be able to come off the ventilator.