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To: null and void

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.


61 posted on 01/01/2009 6:58:29 AM PST by hocndoc (http://www.LifeEthics.org (I've got a mustard seed and I'm not afraid to use it.))
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To: hocndoc
On a related note, from the UK this past September....

Baroness Warnock: Dementia sufferers may have a 'duty to die'

BTW, I love your tagline :)

62 posted on 01/01/2009 7:05:18 AM PST by mewzilla (In politics the middle way is none at all. John Adams)
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To: hocndoc
Unless your dad has been declared incompetent,

He wasn't.

he should have had the discussion with your dad and not you.

*shrug* Dad's 83, and was suffering a temporary ALC. The doc assumed that this was prima facie evidence that he's incompetent.

What the doc couldn't see was that the day before he was as articulate and sharper than 99% of the 30 year olds out there.

Ultimate result? A liter of normal saline and several glasses of liquids later, he's back. Simple dehydration.

Nevertheless, for cardiac arrests in the hospital, approximately 10% ... survive to discharge.

Sounds about right. I taught my students that only about 5% of the people they would do CPR on 'in the wild' would survive.

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.

Yeah. If we'd have had any actual discussion, that would have been reasonable. The doc seemed only interested in getting a DNR order.

70 posted on 01/01/2009 10:52:19 AM PST by null and void (Petroglyphs. The original cliffs notes...)
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