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Do-not-resuscitate law contested by hospital

Posted: March 19, 2012 - 11:06pm  |  Updated: March 20, 2012 - 12:01am

JUNEAU — Lawmakers on Monday debated whether language in the state’s “do-not-resuscitate” law includes the use of cardiopulmonary resuscitation, and if not, whether that should be spelled out more clearly.

Sen. Fred Dyson, R-Eagle River, was approached last year by a constituent with what she described as a troublesome claim.

Margery Mullins said her husband, Mervin, was told by a doctor at Providence Alaska Medical Center in Anchorage that he could not supersede a different doctor’s decision to place him under orders to not be revived using CPR. Hospital officials dispute details of the case.

At the time, Mullins was at the hospital often for a variety of appointments related to his diagnosis of terminal brain cancer, and his story led Dyson to write SB172, which the Senate Judiciary Committee discussed Monday.

Margery Mullins said the recovery of other family members after doctors handed down grave diagnoses, along with faith in God, were the reasons her husband fought to extend his life. He died last month in Providence, and the issue of CPR did not come into play.

“The violations against my husband and I were many, grievous and long,” she said. “During visits (to Providence) doctors and hospital staff deluged us, asking if we would sign do-not-resuscitate orders.”

Dyson said issues of life-preserving treatment like machines that preserve breathing and heart function are well-described in current law. He believes a right to request CPR also exists, but he thinks a clarification of the language would be helpful to insure that patients’ wishes are the prime concern.

“We started working on this to reorder the law so it makes more sense, and that’s what we think this does,” Dyson said of his bill.

An array of legislators and medical professionals disagreed.

“The aspect that troubles me the most about the bill is that a physician could find themselves required to provide care they don’t feel is proper,” said Judiciary Chair Hollis French. He said it would be like asking a doctor to prescribe harmful medication or to perform a procedure like acupuncture simply because of a patient request.

Dr. Stephen Rust, who practices geriatric and internal medicine at Providence, told the committee the bill misses the mark.

“I speak for the entire medical community when I say we support an individual’s right to control their body and what’s done to them,” Rust said. “But it’s ludicrous to say that (a doctor) can’t decline (to perform CPR) for purposes of conscience or medical opinion.”

Rust said a variety of physicians are usually involved in end-of-life care, and CPR is performed whenever a single physician believes it will make a difference.

Dyson said after the hearing that he is still considering whether to move ahead with the current wording of the bill or to rework it to address concerns raised by critics.

The committee held the bill pending further discussion.

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Concerned Citizen
428
Points
Concerned Citizen 03/20/12 - 07:11 am
2
1

It seems fairly clear to me.............

" Do Not Rescuscitate !!" means exactly that. It means no Cardio Pulmonary Rescuscitation !!! See the underlying similarities? Patients have rights that supercede a doctors objections. If a doctor finds that CPR (albeit for the family's benefit) is not within his scope of conscience to perform, then ask a nurse to step in. Nurses have the same CPR training that doctors do. Its not rocket science. If a patient has signed an advanced directive, then follow it... where's the problem? Why do we have to waste legislative time with "big brother" lawmaking tactics? We have much bigger fish to fry in this state than to argue with dying people about how they want to die. Come on !!

hellojuneau1
224
Points
hellojuneau1 03/20/12 - 10:24 am
0
0

It does NOT seem clear to me...

What happens if you do not sign a "do not resuscitate" form? Does that mean that the doctors then have the obligation to resuscitate if asked? And, if you do not sign the forms will you be treated?

skirkz
6719
Points
skirkz 03/20/12 - 12:18 pm
0
0

That's the point.

If a doctor decides to prescribe a "do not resuscitate", then he signs the patient's death warrant. And another doctor cannot step in and try. That is playing God. If the patient won't sign the paper, then the doctor should be obligated to try.
"Can I get a second opinion, please?"

Jo MacNamara
697
Points
Jo MacNamara 03/20/12 - 12:38 pm
0
0

90 years old

If you do CPR on a 90 year old, you risk breaking her chest, ribs, lungs and all kinds of other damage.

Sometimes I think people keep sick/injured people alive not for the sick/injured person's benefit, but for their own selfishness of not wanting to lose the injured/sick person.

Terry Schaivo is the perfect example. She was pretty much brain dead and had been for years. The husband wanted to end her misery, but her parents did not. The husband was portrayed as being selfish whereas it was the parents who were totally selfish.

Then all the self-righteous right-to-lifers got involved, and then the legislators with something that should have been the husband's decision and his alone.

To me, the right to life, liberty and pursuit of happiness also includes the right to die when you want. In my personal pursuit of happiness, I would not be happy tied to life support machines for life, like Terry Schaivo. My happiness would be to transition from life to death instead of prolonging a life of misery and putting my family through my misery.

And, it should be an individual's decision because there is no one-size-fits-all scenario.

I will always sign a DNR order involving any major surgery where the risk of resuscitation could damage me further. I don't want to end up like Terry Schaivo, and I don't want to put my family through something like that.

wmolson
4515
Points
wmolson 03/20/12 - 02:30 pm
0
0

A personal note

In the past, my attorney Bill Ruddy and I drew up a living trust and a living will. In my living will, it will be OK to "resuscitate " me. But if I end up having to live on life support, and especially if I am "brain dead," they can try that for a week or so. But my doctor and I agreed that if after that time period I am not improving, but going downhill he and the medical staff should "pull the plug" on the support system and let me exit life.
As an old man, with a living trust, facing the exit entrance from life, I have my baggage all checked with no carry-ons.
We all fear the end of life, and many hope for a life after death. What we do know is none of us are going to live a biological life here on earth forever. There comes a time when it is time to go.
If others wish to have the medical profession do everything possible, in every way, whatever the expense or burden on others to keep them biologically alive as long as possible, they can let others know that is what they want.

I might point out, however, that even the medical ethics teachings of the conservative Catholic Church says that "one not need take 'extraordinary' means to prolong one's life."
Medical ethics is a very complex study with few simple answers. Individuals can solve some of that complexity by simply letting their family and physicians know what they want.

Do the Right Thing
602
Points
Do the Right Thing 03/22/12 - 06:49 pm
0
0

this is all about setting up for more cash cow lawsuits

Setting up any kind of policy that could force doctors to do what in their judgement would violate the "do no harm" oath would be a disaster of epic proportions.

How could you possibly recruit good new doctors if they may be required to beat on a dead body at the desire of the family?

At what point would this line of laws attempting to govern medical practice stop?

When a patient wants more narcotics that the doctor believes will do harm so they refuse to prescribe them? When a patient or parent of a patient wants surgery that the doctor believes will likely kill them or leave them paralyzed?

Then lawyers would have an even bigger feeding frenzy. People would be suing left and right claiming the doctor didn't really let them know what they wanted wasn't going to be the outcome...or worse suits about how the doctor didn't try hard enough to make the impossible happen and breathe quality life back into a dead and gone body.

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