to think that "Do Not Resuscitate" procedures are just Euthanasia in disguise?

[LadyBlaBlah]

My dad was poorly with cancer. He had been given about a year to live. Unfortunately he got pneumonia. As soon as he was admitted into hospital with the pneumonia, a big red form was thrust onto us saying "Do Not Resuscitate", and so this meant that in the case of cardiac arrest, they would not intervene. The form was placed in the front of his notes, in full view of all (including my dad)

I am amazed this is legal.

The doctors said to us that it would be cruel etc to resuscitate someone whose body was so weak and I get that. But is that not a decision that doctors should take at the time of a cardiac arrest? And not something that needs to be defined so definitely before it happens?

For me, it is just a form of euthanasia. AIBU ? And possibly emotional?

Well of course you are emotional. But I think I would rather let them know whether I wanted a DNR or not when I had the ability to rather than leave the power of my life and death up to a doctor.

Your Dad could have refused to sign the DNR couldn't he?

They didn't even ask him. The doctor was quite clear in that it was their decision and NOT anyone in the family, including my dad

I think that when the decision is made not to give a patient any food or drink that is closer to euthanasia - the end result is guaranteed then, but as it can take days for the patient to die, in my view its verging on the barbaric and and frankly worse for the patient and friends/family then a simple injection.

Not sure what I think about DNR - I suppose there is always the faint likelihood that a patient could survive?

hmmmm that is very dodgy then.

No it's not a form of euthanasia, to not stop a person from dying when they are is different from causing a person to die when they aren't.

I'm shocked though that it was put into your dad's file without his consent - this is wrong. Had he not agreed to it? A DNR is something that needs to be agreed before an event happens not at the time because if such and event as a cardiac arrest occurs then the automatic response of the medical team is to resuscitate so they need to know if the patient does not need this before the event, meaning before any attempt to resuscitate.

Of cause you are being emotional - it is a very emotional time and I am sorry that you are going though it

Sorry for your troubles

You are wrong on the euthanasia, because that would involve ending someones life purposefuly ie using drugs, suffocation ect.

I think you really need to speak to your Dads doctors and find out your Dads wishes.

My nan has a DNR instruction too. I was shocked when I first heard for the same reasons you give
but having seen her slowly deterioriate over the last 12 months I now think it would be a blessing. The poor woman has no quality of life whatsoever and would be crucified by the indignity of the situation had she any mental faculties left, which she doesn't.

Doctors don't gave the time at the point of collapse to sort out family and patient views so they have to get them in advance. Seems horribly harsh, but perhaps it's easier for everyone to be more objective at this point rather than during the extreme stress of possible final moments.

I thought you had to give permission for a DNR!

Sorry your Dad is so ill.
Decisions like these need to be made before the event as during a cardiac arrest there wouldn't be time to start debating the issue of whether the patient should be resusitated.
The form also has to be visible so that all staff know that the patient is DNR.

Have you dicussed your feelings with the medical team caring for your father? You need to.

OK crossed post there - it is not the choice of the doctor it is a choice of you dad's and your dad's alone

Sorry to hear your sad news.

My father also had cancer but requested the DNR himself. At the time I thought the patient had to request the DNR.

But when he was moved from the hospital to the hospice and I saw his doctor; I spoke to her to check that they were aware of his wishes and she said that when patients were as unwell as my father, their practice was not to resuscitate. And I had to totally agree in the case of my father. He was unable to walk, eat and towards the end couldnt even drink. He had no quality of life and his body was shutting down. What purpose would it have served to try and prolong his situation? And put his body under further untold stress?

Re. it being akin to euthanasia....well that is a whole other can of worms.

But YANBU to be shocked; sounds as though the doctors had a senstivity chip missing.

I am very sorry that you and your family have to go through that LadyBlahBlah.

I am quite actually, I always thought DNR forms were given on patient request only, not proposed to them.

I do think there is a difference between eutanasia and DNR though. In my mind, to ressucitate someone they have to be dead in the first place (no heart beat for example or no brain activity) as opposed to Eutanasia where you make the decision to die even though majour organs are still functioning.

Is it possible that your dad had asked the form himself but prefered not to let you know?

How can it be the doctors decision?? they can ot force him to sign if he does not want to or can they?

I'm not surprised you are shocked and upset LadyBlaBlah - the doctors should discuss this with the family and sometimes with the patient first - and a DNR form visible to everyone is very insensitive.

The reason why some dying patients are not giving food and drink is because of the risk of choking and aspiration pneumonia, and risk of overloading, oedema and heart failure. They should always be given enough water to keep them comfortable - in particular to stop the mouth getting dry and sore - and sometimes patients are given a very slow drip of salt/sugar water.

But it is very upsetting for the family to experience.

I'm sorry that your dad is so ill, and that the doctors have been so insensitive in how they have handled the situation.

But I'd also say that not resuscitating is a long way from euthenasia - if the person is very ill, and you're putting them through an unpleasant procedure only to stave off the inevitable for a short time, then that is not always in the patient's best interests. But that's something that should be discussed in a supportive way, not foisted on you single-handed at a difficult time.

I think it is right that the doctors make the decision whether to resuscitate or not, because they know what the result of resuscitation can be - it's not just the resuscitation itself you have to think about, but what happens after that - the continuing invasive treatment that can have very serious complications that may only delay the inevitable without increasing the quality of life.

I am sorry to hear of your situation, of course you are emotional and why wouldn't you? it is a very hard time

personally speaking my mother died of cancer and she most definitely did not want to die in hospital and did not want to be resuscitated
it is hard but proper palliative care is a blessing I hope you all get appropriate suppport

So sorry about your dad. What a thing for you all to go through.

I agree totally this should have been discussed with your father (if he is able) and/or family.

Equally, some CPR measures do not go as smoothly and successfully as shown on many shows on TV. It can be traumatic and the level of force needed can fracture ribs, cause damage to internal organs etc. If the patient is frail in the first place it may be considered too cruel to carry out.

You need to talk to the doctors, ask why this decision was taken.

Interesting - thank you guys

My dad actually died a week or so after he caught the pneumonia and I am just in the process of recounting some of the stuff that went on.

This is one that sticks in my throat - it was never discussed with him - and he was perfectly lucid, it was left out in bright red on his hospital table and the doctors were very clear that it was a medical decision and not one that either the patient or family are involved in.

I can't put my finger on it - but I know there is something not right about this

Will have a look at that link now

My mum had made it very clear to all of us that the didn't want to be resuscitated, she discussed it with her doctors long, long ago. Luckily, we are a pretty open family and talk about these things.

Are you sure your dad hadn't talked to his consultant on a previous visit, or to his GP?

Really sorry to hear about your Dad

A few weeks ago, my dh, fil and bil were called to mil's deathbed. They were asked to sign a DNR form - she will not have known anything about it.
The dr with them was very sympathetic, but also pointed out that in her condition, it would be unfair to revive her, as it would just be delaying the inevitable - probably only for hours. If they felt there was any hope at all, they would have done everything they could.
As far as I know, without a DNR, dr's have to do everything they can to save the patient, even when it's not in the patients best interests.
My fil felt terrible for signing it, and thought that he had given the dr's permission to just let her die. He made an appointment to see her dr a couple of weeks after her death, and this really helped him, as he saw that there really was nothing that could have been done.
If you are not happy with the way things have been dealt with, could you go back and talk to the dr's about it yourself? It may clear things up in your mind.

I am totally positive that it was never discussed with my dad - and because I questioned the doctors quite ferociously about it at the time, it was very clear that it was a decision that could not be made by the family or patient. It was the doctors (single doctor I might add) and there was no deviation from this.