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Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region ForumsA surgeon is claiming that a DNR never applies during surgery. Is he being truthful?
My elderly relative (mid 80's) is having emergency hip surgery tomorrow -- her second -- and she and her medical P.O.A. told the doctor that she has signed a DNR. He's insisting that DNRs don't apply during surgery itself; that if she died on the table they would automatically resuscitate her.
A nurse later said that this isn't true, and gave them a form to sign where they could indicate they wanted a DNR if an event happened during surgery. Will this form mean anything? Can the surgeon just ignore it?
My relatives think that maybe the surgeon doesn't want to spoil his records with a death -- so if a patient's heart stopped, he'd rather get it going again, so the death could happen on someone else's watch.
Is this what's going on? Anyone have experience in this?
Kalidurga
(14,177 posts)It seems kind of logical to me if someone is having a life saving procedure or a procedure to make life better that they should be rescuated if there is an event.
pnwmom
(109,024 posts)not to extend her life but to make it bearable. If her heart gave out on the table, she wouldn't want to be brought back to life. She's not in very good health and doesn't want to spend the rest of her life in a wheelchair in a nursing home.
And the form does give the patient the option of signing a DNR if something happened during surgery. I think the doctor should follow the patient's wishes.
Kalidurga
(14,177 posts)that's why you might need two. But, I don't know. I worked in a nursing home for a while and some patients had DNRs in their rooms over their beds. I don't know if they had a separate DNR for surgery and other medical procedures.
hlthe2b
(102,509 posts)Others fail to address it at all.
This journal article sort of discusses the range of issues (and misunderstandings). Bottom line, you should address this directly prior to any surgery.
http://journals.lww.com/anesthesia-analgesia/Fulltext/1995/04000/Do_Not_Resuscitate__DNR__Orders_During_Surgery_.27.aspx
pnwmom
(109,024 posts)to act on it (and they're in a small town so they don't have a choice in surgeons.)
Hopefully this won't turn out to be an issue. But it's frustrating that the surgeon seems to think he can ignore the patient's clear directive.
Thank you very much for the link!
kestrel91316
(51,666 posts)the meds who did it could be criminally charged with assault. AND sued.
No link, but somewhere in the back of my memory is something about this.
ZombieHorde
(29,047 posts)take the form to the doctor and ask him about it, if he'll talk to you. If he won't talk to you, see if you can talk to the hospital administrators. They won't want a lawsuit.
An interesting situation, in my opinion.
mucifer
(23,609 posts)For surgery, you have to intubate someone. Intubation means the person will be on a mechanical ventilator. I don't see why the doctors would do chest compressions if the person's wishes or the POA's instructions if she is not decisional should include whether or not to do chest compressions.
The other thing to realize is that if she doesn't do well in surgery even if her heart continues to beat but she can't breathe without the machine the family will have to decide whether to turn off the machine that is keeping her breathing and she would die. Which is ok.
The hospital policy might be that chest compressions are performed in surgery.
Some doctors refuse to do surgery if they feel it's too risky.
I'm a hospice nurse. When people are in our program we encourage them not to do elective surgery and use the pain meds instead. But, our patients have a 6 month prognosis.
riverwalker
(8,694 posts)at my hospital.
To have a patient die during surgery, on the table, is a black mark against the surgeon and hospital statistics.