If a person is terminally ill, would you agree to a NO RESUSCITATION policy with Hospital Staff ?

Question

Imagine a 82 year old person is terminally ill, there is a chance of hospitalisation due to a chest infection, the person might go into shock, NOT due to the terminal illness. On hospitalisation you are asked, if staff should resus or not. What would be your decision?

The person is incoherant/in and out of conciousness on admission. Next of kin is being asked the question.

Answer 1

I'm a newly qualified doctor and I've just worked a week of night shifts, during which time I had my first attempt at resuscitation. This woman was 82 and had undergone a major operation. She deteriorated throughout the course of the night and went into cardiorespiratory arrest. Resuscitation was attempted, but failed. And you know what, it was horrible. I though it was so undignified, such a horrible way to go. Instead of letting her just slip quietly away, which I've seen so many times, they were jumping up and own on her chest, pumping her full of different drugs, and in the end it didn't work anyway, they left her lying in the midst of rubbish to die. Instead, she could have slipped quietly away with her family by her side.

This patient you talk about is 82 and terminally ill. They don't have much life left, and probably the quality of life right now is poor. You always have to consider the fact that resuscitation isn't actually all that effective - not in old, ill patients with many other health problems. How would you rather this patient died? Slipping away peacefully in their sleep, or the way I've described above?

That's just my personal opinion. It's your decision. But that's how I feel about it.

Answer 2

That decision needs to be made by that person or someone acting on their behalf if they are not able to make that decision. I would ask the person what their wishes are before going into the hospital. Let them know that no resuscitation (DNR) does not mean that if they are choking on food that nothing would be done. If they would choke, they would have the proper things done to try and stop them from choking. I'm not quite sure what you mean by shock. Do you mean that they might have a heart attack or go into cardiac arrest? What disease do they have? There are a lot of factors. Again, I would ask what they wanted and stand by their decision. There are a lot of people that are terminally ill that actually die from something else. For example, I take care of many people with cancer, and what actually kills them is usually a heart attack or something like that. They need to decide if they want to be treated.

Answer 3

By agreeing to a "DNR" you are not condemning them to a death sentence in their current ill-health - full treatment would still go ahead - what you have to ask yourself is, how ill would that person already be if they reached the point of cardiac arrest, would resuscitating them bring them back to good health, how likely is this given current illness and their age - are they likely to continue life but only with further sickness and suffering? and if they were resuscitated - do you think they would have wanted this? That being said, it is common practise for doctors to ask this question now, medical advances mean they can keep anybody 'going', but doctors recognise that this might not necessarily be right - or wanted! Hope this helps! And remember whatever you decide, you are not doing this alone - the ultimate responsibility lies with the medical team.

Answer 4

Depends on the situation. If the person was given less than six months to live, was suffering horribly, and the person didn't want to be revived then yes I would agree to a DNR. If there is no hope for a remission, pain medication is not working, you know at 82 the person has lived a long life. Sometimes even much younger patients want DNR due to pain and no chance for remission. I agree it is a hard choice to make but sometimes the decision does fall on a younger family member. You could talk it over with the doctor or your minister if you are having a hard time with the decision. Good luck

Answer 5

Ok so this person has a terminal illness, which is not treatable, but with medical care their life has been made comfortable and their life may have been prolonged through medical intervention.

So now this person has a complication..they have become sick with a treatable illness.

Right I Understand…you want to know if you should instruct the medics to withhold any further treatment…’now’? because this person cannot make any decisions for themselves at this time!

I would say rescusitate..because then you have at least given some value to the life of this 82 year old human being who has battled to stay alive this long.

Give them a chance.

Answer 6

I am a nurse and having seen how people suffer in that state ...my personal wishes are for a NO Resuscitation order for myself if I am ever in that state. All it does is draw out the person's suffering and rob their estate of money by creating more medical bills. That's my opinion as I have watched many dying people. The decision has to be yours though and if the family member you are speaking for is alert and oriented you should consult them or think about what they may have told you about their wishes when they were still able (if they are not alert and oriented). In any case a terminal illness is terminal...one day you will not be able to revive them and the illness will take them anyway ...it is just more suffering for them to experience.

Answer 7

That is a decision that must be made by the patient only, if they are able to make the decision. If he/she is unresponsive or mentally compromised at the time of admission, then the closest family member or the one who has his/her medical power of attorney will make that decision. The best thing to do, if the person is of sound mind, is to have them make this decision and the decision of specific instructions to implement when they are determined to be beyond surviving, by making an Advanced Directive or Living Will now. Then the decision is taken out of your hands. An attorney can do this or there are forms at the hospital and Drs. office the person can fill out. They MUST be signed before a notary and witnesses.

Answer 8

you need to get the patients view while they are lucid but in a you gotta answer now situation i would look at the quality of life my father was ill he had had a few strokes could not do anything for himself let alone comunicate he had more wrong than right when asked i said yes to the dnr as i could not watch my always active funloving father just lie there turning slowly into a vegitative state but i will say although i said yes it was a hard decision i had to be sure i was doing what i thought was right for him and not what might be easier for me my father did pull through that night but died a few days later

Answer 9

Terminally ill means they're never going to get better only worse. Personally I could not have them resuscitated only to have them brought back to face worsening of the existing condition causing more suffering.

Answer 10

That decision is, fortunately, left up to each individual (i.e., to each 82-year-old terminally ill person), rather than to hospital staff, or anyone else, for that matter.

Hospital staff have an obligation to resuscitate. That is their job. It's no one else's business.