Why it’s important to have advance directives:

Hazel Wagner has been in Allegan General Hospital’Â’s critical-care unit, where she has been kept alive by a feeding tube and ventilator. She suffered a heart-attack and has failing kidneys and dementia . . .

. . . Court documents filed by Drozdowski say Wagner has “no chance of meaningful recovery,” but the hospital continues to provide costly care, and if she has another heart attack, doctors will do everything they can to save her life.

Apparently state law does not allow a court-appointed guardian to sign a DNR order. Tragic for all involved.

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  • Anonymous

    almost Every Day we deal with situations like this in my Hospital. The fear of Liability is so great that if every T is not crossed or Every “i” not dotted we have to do everything “just in case”. Common problems are unsigned DNR orders or the patient arrives unconscious and the DNR is with some relative in East Nepal. Another problem that is directly the fault of the Lawyers is a patient comes in dying, there is no specific “guardian” and one relative panics and says “do everything”. In a crisis we “do everything” to avoid litigation. I don’t know of any successfull lawsuits for doing procedures on patients who are DNR, only successfull lawsuits for errors of ommision. So we continue to intubate, Lumbar puncture, chest tube 90 year olds who are terminally ill. Your witness.

  • Anonymous

    Yes, it’s the lawyers fault that you can’t just decide on your own whether a DNR is legit or not. And that the family gets to make decisions, when you, a god in your own right, should be making all the decisions.

  • Anonymous

    Ok Doc Know-it-all, You’re in the ER, and an unconscious or demented 90 year old Nursing Home patient comes in (This happens every day). The Ambulance guys say they “think” she’s DNR, but the nursing home has no info. You call the Nursing Home, they (if anyone speaks English at the Nursing Home) tell you she is a “Full Code”. You look in the hospital records she was DNR the last time she came in. You call Next of kin, the number is disconnected, or you get a co-worker who tells you the patient’s Daughter is at Lunch, she’ll be back in an hour. Am I trying to be G-D, Buttmunch? No, I just do every invasive procedure, because i’m not sure. This is a Daily scenario, not an exception. I’m not trying to be G-D, I’m just trying to retire with a pension.

  • Anonymous

    How horrible it must be to have to go to the trouble of using all your skill to keep someone alive in the absence of clear evidence they’d want something different.

    But hey, you’ve got your pension to worry about. And intelligent as you are, I guess you know that a judgment can’t touch your pension?

  • Anonymous

    “How horrible it must be to have to go to the trouble of using all your skill to keep someone alive in the absence of clear evidence they’d want something different.”

    Hopefully when you are 90 years old, your living will will not come along with you from the nursing home, I’ll call over there and some nurse will yell at me in French Creole and Broken English “I don’t Know, he Berry Berry Sick, I don’t know”, and I’ll get to put an unlubricated Foley Catheter in your Urethra, Break what’s left of your rotted teeth when I intubate you, Put a large Bore IV in your neck to give you fluid, a chest tube for your pneumonia, rectal tube for your fecal incontinence, maybe a stat amputation of a gangrenous limb, all because we can’t find the DNR order and we have to do all of the above “just in case” because of the American Liability system. I’m getting excited just thinking about it.

  • Anonymous

    “Yes, it’s the lawyers fault that you can’t just decide on your own whether a DNR is legit or not. And that the family gets to make decisions, when you, a god in your own right, should be making all the decisions”

    “How horrible it must be to have to go to the trouble of using all your skill to keep someone alive in the absence of clear evidence they’d want something different.

    But hey, you’ve got your pension to worry about. And intelligent as you are, I guess you know that a judgment can’t touch your pension?”

    Don’t you love it when people who have no clue what you are talking about, never have been in this situation, yet pontificate and prejudge.

  • Anonymous

    Is the poster you’re quoting wrong?

  • Anonymous

    “Is the poster you’re quoting wrong?”

    Well I don’t know Mr. Sarcastic do you believe?:

    “when you (a doctor), a god in your own right, should be making all the decisions”

    “And intelligent as you are, I guess you know that a judgment can’t touch your pension?”

    I as am an inpt doc I deal with DNR’s, living wills, angry loved ones, dysfunctional loved ones, a combo of the both, etc, etc, all in the setting of people very, often critically ill. These are very tough issues and NOT “sound bites”. I don’t presume to be God, nor do I make clinical judgements based on my “pension” (actually I don’t get one). I give my best professional judgement for the sake of the patient period. So in conclusion YES, I do feel the posters are wrong.

  • Anonymous

    I took the first quoted statement to be a sarcastic reply to the first poster.

    The second quoted statement is correct.

  • Anonymous

    The second quoted comment is incorrect because there is no pension (didn’t he already tell you that?)

  • Anonymous

    Read the last sentence of Anon 2:07′s post. That was what the pension comment was originally a reply to.

    And yes, the statement is correct.

  • Anonymous

    This is pointless. You try to discuss the difficulties of DNR’s/living wills etc etc and you get soundbites from the clueless. Just don’t argue when grandma has 1/2 dozen broken ribs, is foaming blood at the mouth, has various needle puncture all over her body, and is missing a couple teeth with intubation, all thanks to a code because you didn’t bother to have the conversation about code status/living wills beforehand. I guess the difference between the medical non non-medical people here is we know how traumatic a code can be. we have all been through many many “futile codes”, but keep on flogging the poor person for as much “legal” reasons as “medical” reasons. What a sad society we live in.

  • Anonymous

    Well, you have certainly convinced me of one thing. I will NEVER (as in ever) again leave one of my loved ones alone while they are receiving treatment in an ER dept.

    I never knew that the very people who were there to help, might be causing terror (and doing it deliberately) to people who are so vulnerable that they are helpless to stop it..Thanks for enlightening me on ER procedure.

    I will print this out to provide to any ER Doc. who insist I leave the room durrng treatment.

  • Anonymous

    “never knew that the very people who were there to help, might be causing terror (and doing it deliberately)”

    Maam/Sir:
    You are missing the point. Codes are traumatic. This isn’t TV were 90% of all codes get better after one shock. ER the TV show isn’t even close to reality. We are all trained to run codes, but the fact is there are many people we probably shouldn’t be coding. I kid you not I ran a code on a 99 yr old a few weeks ago (she died). If that’s what she wanted…fine. However, after the fact the family was stunned how she looked (even after the RN’s cleaned her up). After the fact they all stated she wouldn’t have wanted this. Then why the HELL didn’t somebody fill out an orange form??? You have to take little responsibility and ask these questions AHEAD OF time. Because when in doubt the default is full code/do everything and beleive me we do EVERYTHING.

  • Anonymous

    anon 11:10…I wasn’t speaking about the things you are talking about. I was addressing the guy who seems to be over joyed at the thought of “sticking an unlubricated foley cath in peoples bladders” among other things.

    I wouldn’t want my family member’s going through that. And, I sure as h*** wouldn’t want any measures taken to keep any 99 yr. old relative alive, when it was obvious, end of life, was the next process. I don’t understand people like that..I just don’t want my family suffering at the hands of some mental ER Doc (there is one or two that post on here) that gets pleasure out of hurting people. Sounds like an oxymoron, doesn’t it?

    I’m sure you aren’t like that, but the thought that some are makes me very nervous of whose hands my families life (or death) might be in.

  • Anonymous

    I think we should send tapes with codes (real ones) to every 80 years old in town and see what happens.

  • Anonymous

    ” I guess the difference between the medical non non-medical people here is we know how traumatic a code can be. we have all been through many many “futile codes”, but keep on flogging the poor person for as much “legal” reasons as “medical” reasons. What a sad society we live in.”

    It’s frustrating when family members, and the actual patient themselves, get to make decisions about their own loved ones, isn’t it?

  • Anonymous

    “It’s frustrating when family members, and the actual patient themselves, get to make decisions about their own loved ones, isn’t it”

    Please read the 11:10 PM comment. Codes aren’t like TV. Have you ever watched a code anon 11:34?