Do Not Resuscitate

Granny Has 'Do Not Resuscitate' Tattooed on Chest: Wise or Wacky?

Talk about an edgy grandma. 81-year-old Joy Tomkins just got inked. But rather than getting a butterfly on her butt, she got the words "Do Not Resuscitate" on her chest. You know, just in case someone tries to save her life or something.  (http://www.bbc.co.uk/news/uk-england-norfolk-14802369/, the earliest web reference)
 

Not so extreme.  Granny is wise to try and get her wishes to be honored.  In the US, some well-intentioned person may call 911.  Paramedics arrive, and they are obligated to "bring her back".  

Unfortunately, here in Arizona USA,  you have to have your wish done in a different manner.  There is a form to fill out, witnessed and notarized, and you're supposed to have a photo of you on there,or at least a good enough description for them to match your unconscious self to the form.  The form is to be on orange paper so it stands out, and you are to have it in your freezer-packet of health info or on the refrigerator or bulletin board so paramedics can find it fast.  Otherwise they have to assume you want to be brought back.  Seems like they would see the tattoo and go looking.  Granny might get her wish if they find her form.  She would also be wise to get in communication with a hospice program--then tell her family and visitors to call hospice rather than 911.  Hospice probably also has some additional forms that make good sense to fill out ahead of time.

Lots and lots of old folks are in pain, both physical and emotional.  They don't get much respect,and relatively few of us get it that they have the right to die with dignity.  Not to kill themselves, but to be allowed to go when it is their time.

Life Care Planning info in Arizona:  http://www.azag.gov/life_care/
Hospice of the Valley (Phoenix): http://www.hov.org/links_and_downloads.aspx

I called 911 two different times for a friend about a year ago, I was visiting her home.  If she had set up the orange form ahead of time I would have honored it.  But that would have been REALLY hard to do.  I am glad she got this year and whatever more time she has left, we have had some good discussions. But she has no life now, just stays at the group home and is not allowed to go out when she wants.  This is a woman who ran a successful business, and who was always out and about. 

This really is an important topic that too few people ever address until it's too late.  Please do make your wishes known to your family and friends and prepare whatever paperwork is appropriate for where you live.  These steps really do take a burden off your loved ones and spare you from frustration and heartache.

Autonomy is a central ethical principle of medical practice. It is definitely true! However, patient's autonomy has a growing influence on medical decision-making and can complicate the process. One area where this is especially true is the manner in which cardiopulmonary resuscitation is disallowed, such as what Joy Tomkins wanted. She decided that she did not want to be brought back to life in a medical emergency that is why a "Do Not Resuscitate" tattoo was inked across her chest. This is to ensure that the health care providers respect her right to die.

Now, what if the medical staff performed CPR when asystole was noted in the cardiac monitor despite the patient's wish against it? Can they be held responsible? Could it be a malpractice case? This reminds me of the article written by Mr. Haskell, a popular lawyer in Spokane WA that has won a bunch of million dollar legal claims. Please allow me to share it. Here it is: Medical Mistakes -- A Primer on the Basics of Medical Malpractice. That will widen your horizons about medical malpractice regarding some medical issues.

To conclude, a DNR request by the patient serves as a formal means of accounting autonomy. It is her life therefore, her willingness of not to be resuscitated must be respected.

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