not coding a non dnr patient - page 2

Have any of you ever had a patient who wasn't DNR and was not coded? Let me tell you the story behind this question. I just recently graduated and I work in the NICU. The baby was about 5 months... Read More

  1. by   Nurse_Wretched
    If anything ever happens to me that renders me barely functional and unable to lead a 'normal' existence, I hope that someone has the sense to let me go! This MD did the right thing. Now the family can move on... What really scares me is when physician's treat patients until they are dead. I had a few really critical dialysis patients that were so sick that they died within days of stopping treatment. One lady would fill up with fluid just hours after returning from treatment. Ridiculous!
  2. by   Faeriewand
    Quote from XB9S
    This is where it is really different in the UK, over here we make the judgment then discuss it with the family but legally it is the decision of the medical team and not the family. We have no legal need to ask consent
    Now that's really interesting. I learned something today. Thanks for the information.
  3. by   Nurse_Wretched
    "no physician is obligated to code a hopeless case..."

    This is not practiced anywhere near as much as it should be!
  4. by   pywon8
    Yeah, I did agree with some of you all ,saying that Doc have to right to decide whether to code a patient depend on patient condition. Even in my country, some of the patient was not code even DNR was not issued. However, doc will keep reinforced to the patient family members about the condition of the patient is very ill.
  5. by   jojotoo
    Quote from ukstudent
    In some States it is legal for the Doctor to make a pt DNR without the next of kin's approval. Where I, the doc would have been in the right if he/she thought that the effort would have been futile.



    Can you tell me what those states are?
  6. by   ukstudent
    I believe that the federal law that gave patients the right to have DNR's also says that if a pt is unable to make that decision then if 2 doctors make the decision that cpr would be futile then they can write a dnr order. I tried looking up which States allow 2 doctors to make this decision even against next of kin's wishes but couldn't find it. I work in DC and this is the law here, I have been told that there are other States that do this as well.
    In the OP case only the doctor running the code (respiratory code all day) is needed to call the end of the code, when further effort is futile.
  7. by   jojotoo
    Quote from ukstudent
    I believe that the federal law that gave patients the right to have DNR's also says that if a pt is unable to make that decision then if 2 doctors make the decision that cpr would be futile then they can write a dnr order. I tried looking up which States allow 2 doctors to make this decision even against next of kin's wishes but couldn't find it. I work in DC and this is the law here, I have been told that there are other States that do this as well.
    In the OP case only the doctor running the code (respiratory code all day) is needed to call the end of the code, when further effort is futile.


    I would be very surprised if the law in DC allowed two (or any number) of physicians to write a DNR on a patient that had no advance directives and that the family did not want a DNR. This just sounds like a lawsuit in the making.
  8. by   TiredMD
    Quote from jojotoo
    I would be very surprised if the law in DC allowed two (or any number) of physicians to write a DNR on a patient that had no advance directives and that the family did not want a DNR. This just sounds like a lawsuit in the making.
    You can get sued for anything; ability to sue has nothing to do with what is legal vs illegal.

    A physician has the right to hold care that he/she believes is medically futile, regardless of whether or not the patient/family desires treatment. The MD does not need anyone's approval, does not need to consult the ethics committee, and does not need a second physician to sign a piece of paper.

    Can he/she be sued for doing this? Sure. But it's perfectly legal.

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