Sunday, June 01, 2014

Do not resuscitate - death with dignity (i.e. minimal suffering)

What better way to spend a Sunday morning than to research "Do Not Resuscitate" (or "Allow Natural Death") orders? I decided to look into this after listening to a Radiolab podcast about how CPR (cardiopulmonary resuscitation) is far less successful than we commonly believe. The distorted view is most likely due to fictional tv programmes, in which people are routinely saved from the brink of death, often going on to make a full recoveries. In reality, the technique is beset with risks, including irreversible brain damage, broken rib cages, etc. I will research this further but given that I have no fear of death in and of itself (it seems illogical as once I am dead, I am no longer around to worry about it), but I do have a fear of suffering, and given that many people instinctively think that lives are worth saving at any cost, I wouldn't mind having some say in when not to be resuscitated.

Not unsurprisingly, this topic can be quite controversial. The likes of AgeUK have been flagging up cases where doctors have issued DNRs (do not resuscitate) orders on patients without discussing the patients' wishes with the patient (they not be mentally competent) or even with their friends or family. My concern is on the other side - that a DNR order is not in place when I would wish it to be. Because of this concern, I have added 'death planning' to my to do list.

For the time being, let it be known that I do want to be resuscitated in temporary situations such as choking, anaphylaxis, and operations where there is a risk that that my heart will stop beating. I do not want to be resuscitated if it is only going to prolong my life for a few weeks or months, and there is a high risk that my consciousness/brain-state will be significantly impaired or/and that I will be in significant pain for a prolonged period. Scenarios might include extreme accidents or the final phases of terminal illnesses.

To all friends and family, if senior doctors/consultants ever decide that a DNR should be in place based on their assessment of the futility of further treatment and resuscitation, I would like this determination to be respected and not to be challenged (maybe even thank the good doctor for making this tough call).

Lastly, I would much prefer for my last moments to be at home versus being in a hospital, however, if this significantly reduces the probability of successful organ donation then the hospital is the best place.

And just in case anybody is worried, please rest assured, I am currently in good health.


Christopher Saul said...

I will bear this in mind!

Riz said...

that's what I like to hear Jeeves