Patients' Rights

Nurses General Nursing

Published

Dear Friends,

I have a question (as it just happened to one of my friends' father)

The doctors decided not to Resuscitate him if he will arest.

My question here:

Does the patient (if possible as it is the case here) or his family to involve in such decision or disagree with the doctors?

Thnx

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There's just the barest of information provided, but I've never heard of a doctor, or doctors, "deciding" not to resuscitate a patient who codes. If the patient has signed a DNR order, that's one thing, but if the patient himself is of sound mind, he has every right and expectation to be resuscitated in the event he codes.

Sounds like someone isn't telling you the whole story, either.

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Specializes in ED.

The family can always disagree with doc. In my area, we use what is called a MOLST form. On the form is a place where a family member, son, daughter or even friend can be appointed as surrogate with the permission of the patient. If the patient is unable to sign or make decisions the next of kin can be appointed. If no one is available, 2 doctors can make the decision for DNR if the patient is terminal or they feel that rescusitation would be ineffective. Sometimes family does not want to make the decision and defers to the doctor. But immediate family should have the last say. The MOLST form also has other directives that can be filled out such as use of antibiotics, IV fluids, tube feedings and even whether to hospitalize the patient. The patient is given the form and is supposed to bring to hospital if admitted. The form is recognized at all facilities in my area. Not sure if it is state wide though.

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well I am sure of the story,

The patient is diabetic, developed renal failur, and arrested once. The doctors decided if the patient will arrest again will not be resuscitated again I am sure I heard this happened before that the doctors decided like this before in the same hospital. I am sad to hear such thing.

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sam, what country are you in?

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Specializes in ICU/ER.
sam, what country are you in?

From Sams 1st post I belive Saudi.

If the story is true one more reason I am glad to be an American..my choice of Docs/hosp and I can have a say in my own treatment and care--some times I think we take some of our basic freedoms from granted.

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From Sams 1st post I belive Saudi.

If the story is true one more reason I am glad to be an American..my choice of Docs/hosp and I can have a say in my own treatment and care--some times I think we take some of our basic freedoms from granted.

well! that would explain it then.....

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Specializes in ER.

Even in America MD's can decline to provide medically futile treatment, but they risk a law suit afterwards, so it is rarely invoked.

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Specializes in Advanced Practice, surgery.
From Sams 1st post I belive Saudi.

If the story is true one more reason I am glad to be an American..my choice of Docs/hosp and I can have a say in my own treatment and care--some times I think we take some of our basic freedoms from granted.

It's similar in the UK, although we discuss with patient and family if resuscitation attempts are considered futile then ultimately it is the senior medics decision.

These decisions are not taken lightly and there is multi-disciplinary discussions and discussions with the patient and family before the decision is made. In fact I have been involved in a discussion such as this today on a elderly medical patient with multiple co-morbitities, confusion, incontinence. This patient is very poorly and is very likely to have a cardio-respiratory arrest in the next few days, she would be very unlikely to be successfully resuscitated and ICU have already said she is not a candidate for level 3 care. There was an agreement that resuscitation would be inappropriate, the family were given the information about her condition and prognosis and resuscitation was discussed with the teams feeling that this would be inappropriate, they were distressed but didn't question this.

I have no problem with participating in this type of decision making.

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well I am sure of the story,

The patient is diabetic, developed renal failur, and arrested once. The doctors decided if the patient will arrest again will not be resuscitated again I am sure I heard this happened before that the doctors decided like this before in the same hospital. I am sad to hear such thing.

Ok, you're sure of the story, but you're also in Saudi Arabia? Well, medical laws and ethics there do not mirror those of the United States, therefore, you already know the answer.

Someone posted that here, too, an MD can refuse to provide medically futile treatments, but it'd be a really RARE one that would do it, given the lawsuit(s) that would follow from unhappy family members. In my experience, patients who have zero chance of a normal recovery and any quality of life whatsoever are brought back from the brink of death time after time, to humor the relatives. Better a patient looking like a Yo-Yo, flirting with death, than be dragged through the courts.

That's ALOT sadder, in my opinion, than simply saying "there's no point here, folks".

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