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Widower in legal fight with hospital http://www.x404.co.uk/forum/viewtopic.php?f=19&t=14584 |
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Author: | cloaked_wolf [ Sat Aug 27, 2011 11:00 pm ] | |||||||||
Post subject: | Widower in legal fight with hospital | |||||||||
Telegraph
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Author: | cloaked_wolf [ Sat Aug 27, 2011 11:02 pm ] | |||||||||
Post subject: | Re: Widower in legal fight with hospital | |||||||||
Guardian
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Author: | cloaked_wolf [ Sat Aug 27, 2011 11:20 pm ] |
Post subject: | Re: Widower in legal fight with hospital |
Having worked in hospital for four years now, this is something that boils my piss. A lot of people have misconceptions about "Do Not Resuscitate" or DNR (aka DNAR). All it means is that if your heart stops beating, a crash team don't come running and try to restart it. It does not mean you cannot have treatment, such as antibiotics for infection, or fluids if dehydrated. There is also a lot of misconception about CPR. Even with best situation (young patient, otherwise fit and well), CPR is about 15% effective, so you can imagine the chances of a 90 year old with pneumonia and a whole host of other problems. The other thing is about after CPR. Even if the 90 year old could be successfully resuscitated, the quality of life is likely to be poor (eg hypoxia leading to brain damage meaning they're likely to be bedridden/dependent). In the article, the widower states the doctors denied the right to prolong life. This is incorrect - no one has the "right" to prolong life. You have the right to refuse treatment, and you cannot demand anything eg if I have a chest infection, I want all antibiotics no matter what the situation. Doctors often don't discuss the DNR status with patients, often if it may distress them, if they have no capacity (eg cannot understand what they're being told), etc. Often it's because the patient is confused/unwell and waiting until they get better isn't an option. They may well have no family/next of kin present. It can also be insensitive to ask - imagine if your mum or dad gets unexpectedly admitted, and you get asked if you want them to be resuscitated. What really needs to be done is that DNR and CPR need to be campaigned to the public to help them understand what it means. A video of CPR (showing the outcome of both successful and unsuccessful CPR) in my opinion should be mandatory. |
Author: | big_D [ Sun Aug 28, 2011 6:49 am ] |
Post subject: | Re: Widower in legal fight with hospital |
While I agree with you, CW, I do think that in this case, if the woman had seen that she had a DNR and had said that she wanted it removed from her records, they should have complied and not snuck it back on when she wasn't looking... |
Author: | l3v1ck [ Sun Aug 28, 2011 7:08 am ] | |||||||||
Post subject: | Re: Widower in legal fight with hospital | |||||||||
The doctors should use their judgement, but if the patient has specifically told them to not to apply DNR, then that it what should happen. |
Author: | cloaked_wolf [ Sun Aug 28, 2011 8:57 am ] |
Post subject: | Re: Widower in legal fight with hospital |
You cannot demand treatment, and that includes CPR. There should have been a good discussion but this isn't always the case. Some people have unreasonable expectations. TBH in this situation, even if she didn't have a DNR form in place, realistically she would have received two rounds of cursory CPR (lasting max 15 mins) and then declared deceased. If successful, the CPR could have left her paralysed below the neck depending on the type of neck injury. |
Author: | Amnesia10 [ Sun Aug 28, 2011 12:58 pm ] | |||||||||
Post subject: | Re: Widower in legal fight with hospital | |||||||||
Yes but with her broken back it would have been very problematic. The problem is that they went about this in the wrong way. If they had spoken to both about this and said if she had a problem requiring CPR that it would have been dangerous to continue. It seems that the consultants were too arrogant to even mention the problems to the couple. That is the problem with many consultants now. They have lost all empathy with their patients. So the outcome is that the hospital will now probably lose more than half a million pounds fighting a legal action that was completely avoidable. They might win but they will still be seriously out of pocket for incompetence. |
Author: | cloaked_wolf [ Sun Aug 28, 2011 2:02 pm ] |
Post subject: | Re: Widower in legal fight with hospital |
I agree they went about it the wrong way, but it was the right decision. She could object all she wants but if a treatment is deemed unsuitable, she won't be offered it. |
Author: | Amnesia10 [ Sun Aug 28, 2011 3:53 pm ] | |||||||||
Post subject: | Re: Widower in legal fight with hospital | |||||||||
But why didn't they make that clear? With her broken spine she would have been paralysed as a result. Was that made clear to the family? If not, then they deserve the lawsuit. |
Author: | Linux_User [ Sun Aug 28, 2011 4:54 pm ] |
Post subject: | Re: Widower in legal fight with hospital |
Unless the patient has specifically requested a DNR, I think doctors should administer CPR in all cases. Allowing doctors to decide whether someone should be "DNR" is very, very wrong. |
Author: | bubbles [ Sun Aug 28, 2011 5:01 pm ] |
Post subject: | Re: Widower in legal fight with hospital |
another case of someone dies and the family wants to blame someone sorry, terminally ill cancer, then she brakes her neck, she was going to die one way or another. Plus, CPR could of killed her, if theres nothing a doctor can do, or if the treatment will kill them, why waste money and time, and if they did revive her, she would of been in all sorts of more pain. why cant people just accept that people die. |
Author: | cloaked_wolf [ Sun Aug 28, 2011 5:06 pm ] | |||||||||
Post subject: | Re: Widower in legal fight with hospital | |||||||||
I completely disagree. Have you read my previous posts? 12-15% success if you're young, fit and healthy. It drastically cuts down the older you are and the more co-morbidities you have. You're talking about essentially assaulting a human body with a tiny chance of success. That tiny chance may well end in someone remaining comatose or severely impaired for the rest of their life. Like all medical treatments, it should be applied in specific circumstances to suitable patients only. Performing CPR on a 90-year old with dementia and poor quality of life (eg bedridden, can't do much other than sip water, has carers 24/7) is entirely inappropriate and probably unethical. As I've said before, most of you have no idea what CPR entails and what the outcomes are. What would you do to the 90-year old I've described, with no DNR in place? Would you resuscitate her? What about when she crashes again ten minutes later? What about when she goes into cardiac arrest the third time? Where would you draw the line? |
Author: | cloaked_wolf [ Sun Aug 28, 2011 5:12 pm ] | |||||||||
Post subject: | Re: Widower in legal fight with hospital | |||||||||
I think it's down to three things: - advances in medical science mean we can treat/prolong life in people either in primary care (eg GP starting patients on blood pressure treatment to lower their risk of a heart attack or stroke) or in secondary care (CPR, life support, advanced treatments). - a change in society's expectations and consumerism where we "demand" or "expect" to live healthy, perfect, problem-free lives. - blame culture/lawyers. The entire notion that nothing is an accident and blame must be apportioned somewhere. Humans have been dying for tens of thousands of years. It can be painful. It can be difficult. There's always someone looking to blame some one or some thing. |
Author: | Linux_User [ Sun Aug 28, 2011 5:14 pm ] | ||||||||||||||||||
Post subject: | Re: Widower in legal fight with hospital | ||||||||||||||||||
Hey if you ask me then it's about what the patient wants, not what the doctor thinks is best. For example, I'm sure there are a few cases floating around where doctors have declared someone brain dead and recommended pulling life support only for the person to come around later. If the patient doesn't recover after administering CPR you haven't lost anything. But to me the idea of denying CPR to someone when they want it is abhorrent. |
Author: | cloaked_wolf [ Sun Aug 28, 2011 5:21 pm ] | |||||||||
Post subject: | Re: Widower in legal fight with hospital | |||||||||
Depends on how you see things. Administering (advanced) CPR takes staff, equipment, time and money. At night time, the crash team may consist of no more than 4-5 staff and that means being pulled from other patients. And how long do you spend on CPR? I've been in a crash call where we tried over an hour for a young kid. How long would you expect to spend on anyone? In my opinion, CPR is medical treatment. You don't give morphine to someone just because they want it. You don't perform an operation just because they want it. You don't perform CPR just because they want it. |
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