A nuanced DNR - does such a thing exist for patients in the US?
I ask this because I was informed the DNR one of my healthcare groups had on file has "aged out" and is no longer considered valid. (IMHO, the real reason is that the system has been bought out and the new owners want this DNR to be standard rather than the former owners' form.)
I read their new one. Slightly paraphrasing, it explicitly states "you stop breathing, we do nothing. Your heart stops beating, we do nothing."
There's no "we will consider the underlying cause of why either of these events has happened." Accidental exposure to fetanyl (however unlikely in my personal life) is a prime example of where I would appreciate medical professionals or anyone having the common sense to consider restarting my breathing and heart would have a beneficial outcome before deciding not to make any attempt.
I would like a DNR that says, "underlying cause should be given weight to the decision." But then I guess a DNR stops being a DNR at that point, and ends up being a nightmare for navigating.
I have chronic medical issues. I have the potential to be one of those patients whose bodies are slowly shutting down and there is no hope for any sort of quality of life if my life were artificially extended.
I don't want heroic measures taken. I want common-sense measures taken when not blocked by a DNR.
My previous DNR had those provisions. They've been stripped from this one. I'm getting the "you need to have one on file with us" pressure every contact I have with the doctors. I agree. I just don't want to have on file the one they want me to sign.
So, if you've made through my rambling, what are my options for letting medical care providers off the hook from having to keep me alive when there's no good reason while still giving them empowerment to make a good-faith attempt if there's strong possibility of a beneficial outcome for doing so.
Posted Mar 27, 2022, 2:06 PM UTC
You can have and file a living will document that has these specifications. Some states also have a POLST/MOLST that allows more granular instructions than a DNR.
There are no circumstances where you should feel forced to sign a standard DNR form if you don't want to, and you should report anyone that tries to pressure you to sign a standard DNR against your will to their appropriate board.
Thank you for this info.
Both my wife and I do not want others to attempt to keep us alive when all they're doing is reanimating a corpse.
I'll add that what I counsel patients is to talk about this with their kids or whoever their most likely surrogate decision maker will be, because ultimately, your family can override these in emergencies.
I joke with my kids all the time that if they're sitting around waiting for me to draw my last breath and their phone's battery is about to die, they can unplug me to charge it.
I don't fear any of them interfering. As for "cousins from California", there aren't any.
They are all aware my body's going to give out and that is perfectly fine with me. My wife and I have reciprocal Durable Power of Attorney docs for both health and finances. We've already talked to one of our sons as to him eventually being empowered.
Anyhow, my wife and I want to get this issue ironed out asap. COVID being what it is, our health risks have greatly increased. I don't want my kids having to deal with making the hard decisions if I can prevent it.