Comments on: Discussing DNR http://www.kevinmd.com/blog/2007/12/discussing-dnr.html Tue, 14 Feb 2012 11:46:00 +0000 hourly 1 By: Pei Loohttp://www.kevinmd.com/blog/2007/12/discussing-dnr.html#comment-82008 Pei Loo Tue, 04 Dec 2007 20:57:00 +0000 http://clients.emmense.com/kevinmd/2007/12/discussing-dnr.html#comment-82008 "Any data to support such an extraordinary claim?<br/># posted by Gasman : 12:50 PM"<br/><br/>Have you visited a nursing home lately? “Any data to support such an extraordinary claim?
# posted by Gasman : 12:50 PM”

Have you visited a nursing home lately?

]]> By: Gasmanhttp://www.kevinmd.com/blog/2007/12/discussing-dnr.html#comment-81969 Gasman Mon, 03 Dec 2007 17:50:00 +0000 http://clients.emmense.com/kevinmd/2007/12/discussing-dnr.html#comment-81969 Perhaps Pei Loo would rather see people who have run out of beneficial medical options be subject to all manner of non-beneficial interventions that they do not wish.<br/>The point of DNR is to define in advance what interventions have burden but little or no utility as judged by the patient. The article merely cited the problem that occurs when the decisions are deferred until the patient cannot participate and such decisions are left to surrogates. To assume that an entire generation of people born in the 40s through the 60s will handle the surrogacy poorly seems a bit of a stretch. Any data to support such an extraordinary claim? Perhaps Pei Loo would rather see people who have run out of beneficial medical options be subject to all manner of non-beneficial interventions that they do not wish.
The point of DNR is to define in advance what interventions have burden but little or no utility as judged by the patient. The article merely cited the problem that occurs when the decisions are deferred until the patient cannot participate and such decisions are left to surrogates. To assume that an entire generation of people born in the 40s through the 60s will handle the surrogacy poorly seems a bit of a stretch. Any data to support such an extraordinary claim?

]]> By: DDx:dxhttp://www.kevinmd.com/blog/2007/12/discussing-dnr.html#comment-81967 DDx:dx Mon, 03 Dec 2007 17:22:00 +0000 http://clients.emmense.com/kevinmd/2007/12/discussing-dnr.html#comment-81967 Here's an example of how ineffective "Central Authority"...Medicare/ HCFA regulations are. Every patient entering the hospital is required to have a "code status" recorded. Since it is a difficult discussion that takes time, tact, training even, AND is essentially uncompensated, the admissions clerk usually types in "patient could not signify"...and we all keep just doing the wrong thing because it's easiest.<br/>Sorry, I don't think docs "unburden" themselves of patients, as Pei Loo suggests. But they do unburden difficult, awkward, unrewarding tasks. It is difficult to discuss deeply heald personal beliefs(Life/Death, god, etc) when you have to round on 20 pt.s and you haven't met this person before, you're covering for the weekend... Here’s an example of how ineffective “Central Authority”…Medicare/ HCFA regulations are. Every patient entering the hospital is required to have a “code status” recorded. Since it is a difficult discussion that takes time, tact, training even, AND is essentially uncompensated, the admissions clerk usually types in “patient could not signify”…and we all keep just doing the wrong thing because it’s easiest.
Sorry, I don’t think docs “unburden” themselves of patients, as Pei Loo suggests. But they do unburden difficult, awkward, unrewarding tasks. It is difficult to discuss deeply heald personal beliefs(Life/Death, god, etc) when you have to round on 20 pt.s and you haven’t met this person before, you’re covering for the weekend…

]]> By: Pei Loohttp://www.kevinmd.com/blog/2007/12/discussing-dnr.html#comment-81963 Pei Loo Mon, 03 Dec 2007 15:37:00 +0000 http://clients.emmense.com/kevinmd/2007/12/discussing-dnr.html#comment-81963 Selfish and heartless Boomers find this approach useful, when care of their parents begins to burden them. Selfish and heartless Boomers find this approach useful, when care of their parents begins to burden them.

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