Do Not Resuscitate = License to Legally Kill

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OLYMPUS DIGITAL CAMERADNR is short for Do Not Resuscitate.  If it is on a person’s medical directive, their chart, or on their hospital patient bracelet, if they code for any reason, including choking, they are allowed to die, no questions asked.  I never thought much about it until my sister called me Friday morning.  My sister is the calm one. I am the bitch.  “Did you know they have a DNR on your mother.”

“What’s that?”
“Do not resuscitate.”
“How?” I asked.
“You were there all day, how did it happen?”
“I didn’t do it.”
She was driving from Memphis to New Mexico, fast, trying to get to our parents. I was told to call the ICU and have it removed. Naturally, I threatened them with our attorney. The ICU nurse was shocked that it was there. My mother told her to immediately remove it, which she did. According to NM law, the damning page was destroyed.

How did it get there?  That was the next question.  Exhausted, it took me awhile to think about it.  Everything started Wednesday, when my mother came in to town with my father, who has Alzheimer’s.  He will be 90 in June.  She is 84, exhausted from care-giving, and in relatively fragile health, herself, having a pace-maker, history of heart failure, and in chronic pain from osteoporosis and fibromialgia. She is dealing with chronic vertigo from an auto accident last summer (not her fault), and is having a serious problem breathing.  She’s on oxygen 24/7 her oxygen saturation is so low.

Wednesday was a good day. I was exhausted after 6 hours dealing with my father.  I don’t know how she does it.  I was so tired, I left my non perishables on the kitchen counter (where they still remain) and crawled off to bed.  The following morning she called, getting ready to come into the ER, her breathing was so bad.  It should be noted that she could barely breath or walk on her own, but she did stop to shampoo her hair.  Maggie, a friend, drove them in, stopping by the condo to get me.  By the time we reached the ER, they did not even put her in triage, but took her inside, immediately.

Long story short, by 5PM they knew she was having a problem with her pace-maker.  A tech was sent up from Las Cruces to recalibrate it.  Her PK levels were a little off.  She had a few other problems, including a toxic level of one of her cardiac meds.  She was being treated incredibly well in the ER. I was impressed.

Around 5PM, when they were getting ready to move her to ICU, the ER nurse thrust a paper in her face, asking her to sign it.  Exhausted, barely able to function, she did, telling me she did not like what she was required to sign.  I asked what it was.  The ER nurse asked if she had a medical directive or did she need one.  I told him that my sister and I have medical power of attorney, and copies of the medical directive, which were made up by our local attorney.  Nothing more was said.

As they were wheeling her to ICU, I separated, taking my father and Maggie back down to San Patricio, and picking up things she needed.  By the time I returned, it was 7:30.  A friend was up in the room, with her.  My mother was almost hysterical, saying she didn’t want to die, that she was afraid she was going to die.  Having been there while the attending physician made his rounds, then waiting until after 10PM, I knew that she had a bad UTI infection.  The same thing killed her older sister a few years earlier, so that would upset her.  Her heart was good.  She’d not had a heart attack.

I wasn’t paying much attention to the fact that they had put a DO NOT RESUSCITATE bracelet on her, and told her they were monitoring her for a heart attack.  She said nothing to me about it.

I did not head home until after eleven.   The follow morning, I was working the phones by 8:30AM.  My sister called about 10AM or so, telling me about the DNR.  But – she didn’t sign anything.  Nothing was said.  Why would they even have one?

Fast forward to Sunday evening.  Now home, my sister and I were discussing, with our mother, why the DNR was even there.  I was with her almost the entire time (with the exception of 30 minutes when I was running an errand) while she was in the ER.  I was there when the form, containing the DNR was pushed in her face.  Nothing was mentioned that it was a Do Not Resuscitate directive.  According to New Mexico law, the entire process must be explained.  It was not.  My mother had no idea, at all, what she was signing.

She was literally signing her own death warrant.

My sister, who was once a nurse, was fortune enough to catch it and call her ex-husband, who is a physician.  Once he calmed down, after discovering what had been done, he told her to call me and have it removed, immediately.  I was not that polite about it, when I did.  I was furious.  Then, I realized the DNR had been pushed on her, in her weakened state, never explained.  She was never given an opportunity to refuse, not even knowing what she was signing.

If something had gone wrong, they would have allowed her to die, before we discovered the mistake, and had it removed.  How many perfectly viable men and women have been pressed into signing something like this, and have literally been allowed to die, not knowing what had been done to them?

How many families have been left with questions, and no legal recourse?

How can hospitals and physicians get away with what is literally promoting legalized doctor non-assisted murder?  Politically, during the discussion about the ACA – Obamacare – all the talk was about death panels and how people would be allowed to die.  With poorly regulated DNRs you don’t need death panels.  You don’t need euthanasia, or even a medical consultation.  Some poor, stressed out person or family member signs something they don’t know they’re signing, and their loved one is allowed to die.  Unless the person who signs the paper, or someone with medical power of attorney stops it – they must be allowed to legally die.

It is a license to kill.

Don’t get me wrong, if something happens and I have much in common with the veggies of the field, pull the damn plug.  But, if a person has a bright future, but something happens, and they can recover, not allowing them to do so, because of a coerced signature on a legal form is literally murder, plain and simple.  It is legal murder.  If a hospital cannot properly advise patients and families of their rights, then it should not be allowed.

As a care-giver, I am livid.  I am also terrified. I’ve spent the past nine years of my life being there for my aging parents, insuring that everything is as good for them as it can possibly be.  To have every precaution, every single thing my sister and I have done, destroyed, because of a death directive that was not explained is criminal.  The more I think about it the angrier I become.

My mother was traumatized over the incident.  She still is not over it.  There is absolutely nothing we can do to bring back her peace of mind.  But, we can warn others.

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7 thoughts on “Do Not Resuscitate = License to Legally Kill

  1. Thanks for sharing this. I think this really bolsters the argument for discussing and planning “advanced and/or end of life directives” while still moderately healthy and never in an emergency situation. I’m sorry your mom had to face that kind of shite. I hope you will consider filing a complaint with both the hospital and the state’s hospital board or whatever governs them.

  2. I’m trying to figure out what to do. We have all the legal paper-work, which is why I don’t understand why this was even necessary.

  3. Sometimes I think too many employees get stuck on task and they’ll just push to fulfill the task, whatever it is) without really thinking about it. As heartless and automaton-like as it may be, lower staff in most institutions have it ground into them to get the stuff signed and the trainings don’t include when it’s not appropriate to press for signatures or actions that have far reaching consequences. The culture is mechanized and reduced to rudimentary functions. And it’s sad and infuriating to see, particularly when it involves the people you love the most.

    May I suggest that you put together a binder with three tabbed sections, one for each of your parents, that can always go with them to the doctors and, if needed, to the hospitals? The first tab section Medical Information should have a page 1. their primary & specialist doctors, page 2.) list of all their medical diagnoses and page 3 (and more if needed) current medications, dosages and frequency and so on with the most recent on top. The second tab section should be Legal Information: the first documents should include “certified true copy(ies)” of your and your sister’s medical power of attorney documents. The second should be your and your attorney’s contact information. The third documents should include your mothers true “advance directives” and desires as well as instructions over who has signing authority for DNR forms. The Third section should be a Visit or Event Log on a spreadsheet. Simple column headers: Date Reason. Attending Physician. ER Nurse Time In Time Discharged.

    And do you and your mother have a respite caregiver you can hire for 4 hours a week to be with your Dad so she and/or you can take a morning or afternoon to rest, recharge, exercise or whatever just for relaxation? As long as your father’s physical health permits, you don’t need a medical caregiver… just someone who will be there, make sure he gets a meal, keep him company and who will follow your instructions? If not, I seriously recommend it. Your mom shouldn’t be exhausting herself.

  4. I have everything organized, that way. I even have copies of everything via iPhoto on my iPhone! We’re in the process now of trying to figure out how to do the care-giver thing, and it is daunting. My mother has basically nearly killed herself care-giving (and it wasn’t necessary). We’re now trying to figure out if we can get home health care, in home over-night care, just what is available through their insurance. It is a learning process. She is in very poor health herself, and has made it worse by the way she has acted, just 24/7 for five years. It’s like she’s an addict. My father is having a blast this week. This is the happiest I’ve seen him in ages – he’s getting so much diverse attention, meeting with his buddies, out socializing. He’s in good health, and is a social butterfly. She would not go out in public, locked herself up, almost. I want to bang my head against the wall. My mother is now the one who needs a medical care giver. I am so angry with her!

  5. It sucks to feel angry with a parent and I’m sorry you’re having to deal with that kind of emotion at this time.

    I do independent work as a caregiver and previously worked for an agency. I went independent to work with a friend of the family. I will suggest that you be careful with agencies and make sure anyone they send to you is bonded and insured. Frankly, the agency makes the money from Medicare and the worker gets minimum wage for all they do. Unfortunately, because they pay so poorly, turnover is fairly high. Also, if you can afford it, don’t discount hiring independent, non-medical caregivers either for those times when you need to fill the gap between agency/program workers.

    Also look into more informal stuff – maybe community based programs like senior companions where volunteers visit for a couple hours a week and stuff like that. This is what the City of Albuquerque program guide shows: http://www.cabq.gov/seniors/documents/DSA-I-A%202014%20Quick%20Guide.PDF

    So hopefully, there is something similar in their community. I sent you a pm with my phone # on Twitter if you need.

  6. THANK YOU! I’m not near as ticked as I was. We’re trying independent, if possible. Right now, we think if we can expand my mother’s cleaning woman’s hours (she’s so wonderful) and have someone come in for nights for awhile, we’re okay. My mother’s GP laid her low today on her health. I like him – he doesn’t put up with her sh*t! She has home health care coming for nursing visits and for PT. We go to her cardio on Monday. I would rather go independent if we can – I feel better about it. My sister and I have also talked about using several different people. Don’t want just the same person there all the time. You never know about people. Your email pops up on the comment, (which is hidden). I’ll use that, if you don’t mind.

  7. Go ahead and use it. I also PM’ed you on Twitter with my phone number if you ever need to pick my brain.

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