The Do Not Resuscitate Order

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The Do-Not-Resuscitate Order




Guest:  Dennis Christensen – Elder Law Attorney

Host:  Sally Smith – Author/Resource literature on age-related disease and healthy aging


Sally Smith:  Welcome to Age to Age.  I’m Sally Smith.  Let’s talk.  We’re talking with Dennis Christensen, our elder law attorney, who has been kind enough to share his good knowledge regarding documents as one moves into the later stages of life.  One that we’ve all heard quite a bit about is the Do-Not-Resuscitate order.  What is the Do-Not-Resuscitate order?


Dennis Christensen:  One thing about all of the documents, including this one, is that these are the documents that all of us should have, not just people who are elderly.  Any of us can be one car accident, one medical condition, from having these same issues.


Sally Smith:  Good point.


Dennis Christensen:  So, they really apply to all of us.  And the only requirement is you need to be over 18 to sign most of them.  Now, the Do Not Resuscitate order really arose out of a conflict in the laws for South Carolina that a person can have a healthcare power of attorney.  If you’re in a hospital, or your home, it tells the physicians and healthcare providers whether or not you want to be kept alive under certain medical conditions.  But, when the EMS vehicle comes to your house and picks you up, by state law they have to do everything they can to keep you alive during the transfer from your home to the hospital.  So, even though you have a healthcare power of attorney that says do not resuscitate, when the EMS vehicle comes, they will have to resuscitate you to get back to the hospital.


There was a situation, some time ago, where a person was dying from cancer.  The doctor was there with the family, in the house.  The person dying was making the gurgling death noises, a neighbor heard it, got concerned, and called EMS.  They got there, the doctor showed them the healthcare power of attorney, and they said, we don’t care.  They’ve got a legal obligation to transport.  So, the person was put on machines and taken to the hospital.  After getting to the hospital, they [the family] could discontinue them.  But this person lived for some period of time after that.


So, this Do Not Resuscitate order is directed to the EMS services.  In essence, it orders them not to resuscitate or use heroic methods to someone alive while transporting them to the hospital.


Now, this document is not one that you can sign.  This document is signed by your doctor.  It requires that someone have a terminal condition.  Now, what terminal means is somewhat debatable.  But this is not a document in which you can go to a lawyer’s office and sign.  Only a doctor can sign this for you.  Then, you just need to keep that near you.  If you don’t want EMS to try to resuscitate you, this is the document you need.


Sally Smith:  Well, I understood, from something I read, not long ago, that even with a Do Not Resuscitate order, signed by a doctor, and shown to EMS, they still will not honor that.  They have to have their own document, prepared by them, a separate document.


Dennis Christensen:  There is a state form that’s the Do Not Resuscitate document.  In other words, it’s a form, just like a healthcare power of attorney or a living will.  All of these documents, there’s a state form, and that’s the form.  If you just have a letter written by the doctor that says do not resuscitate, that’s not sufficient.


Sally Smith:  Okay.  Can you download these forms?


Dennis Christensen:  You can download them, but the doctor has to sign it.


Sally Smith:  Well, yes, but where you can just read it?  I know you can download certain forms for wills, state by state.  Is there a website in which the state puts out forms like this?  I mean, would you take it to the doctor and say, this is the form, would you sign it?


Dennis Christensen:  In our experience, when we have clients who want that document, we have provided them with the form that they take to the doctor.  I would guess that if you went to your doctor and wanted one of those, either they would have that form, or would be able to obtain it.


Sally Smith:  I see.  And the key here is to, really, have it right beside the person.  You can see how an EMS person, trained to rush in and save someone, they can’t stand around talking about where the form is.


Dennis Christensen:  And, again, this is why you certainly wouldn’t want to put this document in a safety deposit box in bank.  You don’t have the time to go to the bank.  So, it would be a document that you’d want to keep in the room and readily available.


Sally Smith:  You know, one thing this brings up is the comfort level our society has with death.  There are so many people that shouldn’t call 911; they shouldn’t call EMS.  There needs to be a time when somebody, as with the situation you just spoke of, is allowed to go and die.  I’ve heard of attendants, sitters, for older people calling and starting this whole process, when the person, really, was just at the end of life and needed a chance to go on and die peacefully. 


When you think about what happened in the scenario you described, what trauma for the person that was dying.  Instead of having the peaceful bedroom with the doctor and the family around, he’s jerked out of there, and all these things are done to him, and he dies anyway.


Dennis Christensen:  Well, if you want to get an argument going, when you start talking about end of life issues, you’ll get one started.  The best example is this whole issue about Terri Schiavo down in Florida, the millions of dollars that were spent, all of the congressional, presidential, governmental things that were done.  There really is a debate about what rights people have to interfere with the natural process of death.  Does someone have the right to die, or are we supposed to keep them alive at all costs?


We’ve had families where the children would fight for hours in our office about whether or not Mom should be kept alive on life support.  Some believe that life support goes contrary to the will of God, and some believe that it’s not right to let someone die.  It’s such a personal and spiritual thing.  It, really, can create problems even within a family.  That’s even more reason to eliminate those fights, to have healthcare powers of attorney, living wills, Do Not Resuscitate so that your wishes are going to be followed, and you’re not going to end up as a ping pong ball, where, instead of your last moments being spent peacefully, you’re in fights with lawyers.  That’s why these documents are so important.  We’re trying to take the legal process out of health issues, and out of dying, rather than having whether someone lives or not decided in a courtroom with judges and lawyers.


Sally Smith:  That is so important.  What a topic.  Thank you so much for those comments, Dennis, and thank you for being with us today.  And thanks to all our listeners for joining us.  We welcome your suggestions.  This is Sally Smith, Age to Age, saying goodbye and wishing you courage and joy on your journey.  We are all connected. 


If you enjoy listening to Sally Smith, you can buy her book, The Circle.  It’s the story of how she personally responded to her mother’s journey with Alzheimer’s disease.  It’s a wonderful gift of hope for anyone with a parent with dementia.  Just click on Sally Smith’s name under the Health Professionals tab on the Podcast home page.  All profits support research at the Center on Aging.  Thanks.

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