93-years old, full code

February 9, 2008

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{ 2 comments }

1 Anonymous February 10, 2008 at 9:05 am: When I was an intern, I had to run codes in two different hospitals that had no higher level housestaff. In one, the chief made it clear that a code was like any other medical care–it was subject to medical judgment, and if we were called to code someone who we found an inappropriate subject, we were free to make a judgement call and desist even in the absence of a DNR order by the attending.

In the other, the policy was to code anyone who was not DNR. I came out with a fear of being mortally ill in the later hospital.

My question is, do doctors still have the professional responsibility for making judgments about such things, or are we mere technicians following protocols.
2 Gasman February 10, 2008 at 11:50 am: ‘Full code’ is a default status to the added conditions on limitations for resuscitative efforts.

You are not obligated to provide all of the interventions rattled off on your list:
“ICU
Central line
Ventilator
Tube feeds
Drips
Drops
Pulling out all the stops.”

You are obligated to use judgement and discression as a physician. Provide those elements of care that have some reasonable probability of providing either quality or quantity to life. You cannot do these things as a mindless automaton, then complain that it was you who initiated inapropriate care. If you want to be a physicain, then be one; if you want to be a technician in ICU care then shut up and follow the protocol.