Texas now has legislation in the works that would allow
doctors to hypothetically place a DNR, or do not resuscitate, onto patients
charts with out informing the patient or a surrogate to give doctors
permission. This is the first piece of legislation of its kind and its goal is
to lower the cost on the sate or hospital for patients who are going to die
imminently. Unless explicitly stated doctors can put this DNR order on the
charts of patients who are expected to die soon. This legislation is not meant
to be applicable to patients who are going to die within month or weeks but
only those who are going to die within days.
The
rational, as stated above, for this is to save money. The hospitals don’t want
to pay to keep someone who is in dire shape alive for several days until they
find a surrogate to decide weather or not the patient wants to be kept alive.
Keeping the patient alive for this search costs money, money the surrogate or
patient could very well not have. This means the state or hospital would have
to pay for this week of life support.
Even with
this rational in mind it is absolutely ludicrous that the doctors can decide
for a patient, with no consent weather or not to resuscitate them. The idea of
deciding if someone wants to be kept on life support being up to the doctor
like this legislation suggests is insane to me. The patient should clearly
state if they would like to be kept alive on life support before any accident
that leads to this decision being made but if not, the decision should be left
up to the family of the patient. Not the doctors. There has to be another way
to pay for the life support that makes more ethical sense than just deciding to
take a patient off of life support without contacting a surrogate to make the decision.
http://www.cbc-network.org/2013/02/forced-dnr-coming-to-texas/
1 comment:
From first impressions, I agree with your judgment that non-voluntary DNRs are ethically backward. But one complicating factor hospitals have to take into account is limited resources. When the possibility exists that the hospital will pour time and resources into a patient who is expected to die within days, and the patient's family is then unable to pay, one important question immediately arises: how could those have been used differently?
In the context of a hospital, it is quite plausible that the cost of saving one life be losing another. Is it, then, unethical for the hospital to take these admittedly difficult cost-saving measures?
The question remains a difficult one, but it is important to be pragmatic about the way we approach questions like these. Of course, a world where everyone could have unlimited resources devoted to saving her life would be ideal, but this is not the world we live in. Hospitals do not have unlimited money, let alone unlimited time, to spend on each patient. Using these wisely is crucial.
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