I was chatting with a woman I met at the hair salon when the issue of healthcare came up. Rita promptly told me that she had decided on a DNR: a “do not resuscitate” request. When I asked about its effect, Rita had no idea. She admitted, “Both my mom and dad suffered horribly. I am not going to die the way they did.”
Rita’s declaration is shared by many who have watched a loved one struggle with cancer or heart disease. In some of these situations, a DNR may be appropriate. But, let’s unpack the possible scenarios where a DNR could be used.
When a patient stops breathing or her heart stops beating, a DNR order should prevent the medical staff from trying to resuscitate her, whether by performing CPR or hooking her up to a ventilator. A blanket DNR does not consider the medical condition of the patient and the likelihood of recovery. This is an important factor.
Several years ago, a loyal Steelers fan went into cardiac arrest in the final minutes of a divisional playoff game against the Indianapolis Colts. Two firefighters attempted CPR and saved the fan’s life.[1]
Even more remarkable is the case where a man was revived after his heart had stopped beating for an hour and a half. EMTs on the scene had no success at the hospital; the surgical team was getting ready to remove his organs for transplantation when he began to breathe on his own, and his heart started beating. Today he’s walking and talking.[2]
I don’t know if either of these men had a DNR order. If they did, I suspect they are pretty glad that they were resuscitated, not angry because their written wishes weren’t followed to the letter.
Now granted, these cases are highly unusual. But, they point out at least two things. First, when we think we’re making one kind of end-of-life plan, we may not fully understand the extent of the document we’re signing. Second, we cannot predict future medical events.
Advance care planning is an important aspect to maintaining patient autonomy, but we need to take responsibility. When we say “we don’t want to die like Mom or Dad,” we just might discover that we very much want to continue living. Or, we may have peace that we are dying and medical procedures would be an undue burden. A patient has the right to refuse medical treatment.[3]
As Christians, we are encouraged to have wisdom. Let’s be wise even in things like DNR requests. And for all the “Rita’s” out there, I empathize with your desire not to end like Mom or Dad. Just make sure that you don’t choose a “DNR” that translates into “Did Not Read.” Be wise.
[1] Tony LaRussa, “Man’s Heart Stops after Bettis fumble.” Tribune-Review, Jan. 16, 2006. http://www.pittsburghlive.com/x/pittsburghtrib/s_414153.html (accessed on May 10, 2010).
[2] “Frenchman’s [sic] Wakes Up Just as Doctors about to Remove Organs.” Herald Sun, June 11, 2008. http://www.heraldsun.com.au/news/world/back-from-dead-case-stuns-doctors/story-e6frf7m6-1111116602182
[3] A competent person has the right to refuse medical treatment. (They might have a moral obligation to continue.) A durable power of attorney for health are, executed while the person is competent, names an agent who would step in if the patient becomes incompetent.