If a senior is admitted to hospital and their heart stops, staff will automatically do CPR (Cardio-Pulmonary Resuscitation) unless there is an order to Allow Natural Death (AND). The AND is the same as DNR—Do Not Resuscitate—which means only “Don’t do CPR”, which is what most seniors tell me. But to avoid it, their doctor must write an AND/DNR order.
The following are reasons why an AND/DNR order should be written [for the references and more information, go to my website comfortcarechoices.com ]:
CPR is rarely a beneficial procedure: at best, fewer than 17% survive, with more often fewer than 5%, and most survivors testify they wish they had not been resuscitated.
Particularly for those with a life-limiting illness, CPR is a harsh procedure incompatible with a peaceful death; it offers only false hope when we should be helping families prepare for the final stage in life.
Although most seniors will develop signs of approaching death, allowing an opportunity to write an AND/DNR order, many have an unpredictable crisis—often in the middle of the night—resulting in unwanted CPR.
Seniors with life-limiting illnesses do not want the dying process prolonged; they want honest information, to be comfortable, to be listened to, and to be part of the decision-making process.
When a treatment is futile, the AMA states physicians are not ethically obligated to provide it, even if families request such.
Finally, in an uncertain world, patients expect their physician to discuss End-of-Life Care issues with them and respect their choice.
Next time: living in a world of uncertainty.