It’s always tragic when a loved one passes but even more devastating when end of life planning is not in place, or worse yet, when that planning fails.  In the linked to article from Fox 13 news that aired last night, this is one such situation where things can go horribly wrong despite best intentions.  According to article and lawsuit,  Marjorie Mangiaruce, 91, had a DNR in place, appropriate signed by her doctor, though that important fact was not apparently known to the Healthcare Center she was staying in.  Then, when an emergency arose, she was transported back to the hospital where invasive and emergency measures were used in an attempt to save her life.  The full article, and video can be viewed through the attached link.

Two important issues come to mind from this article:

• One is the importance of patient advocacy by family members – In a medical setting, it never hurts for you, as an advocate for your loved one, to remind healthcare professionals of important details.  Ask questions, relay observations, and verify information has been exchanged.

• Understand the difference between the various types of healthcare forms and this is so important let’s go ahead and review:

DNR

First off, DNR’s are not for everybody!

The “Do Non Resuscitate” Order is a very specific form, with very specific requirements to be legally valid, that says a patient does not wish to be resuscitated in the event of respiratory or cardiac arrest.  I say that they are not for everybody because most people would want to be resuscitated in such an event.  The DNR Order is usually only for patients that are already in a terminal condition, a persistent vegetative state or an end-stage condition.   This concept is sometimes often confused with the function of a Living will or Health Care Surrogate Designation.

Health Care Surrogate Designation

This type of form IS for everybody.  The Health Care Surrogate Designation allows you to decide who you would want to make medical decisions for you in the event you are unable to give informed consent for medical treatment.  This situation may arise in both an end-of-life scenario as well as a non end-of-life scenario.

Living Will

This type of form IS also for everybody.  The living will is a broader statement of your views on end-of-life interventions.  This allows you, as a patient, to decide what types of “interventions” you are comfortable with in the event you are in an end-of-life situation (typically defined as being in a persistent vegetative state, end-stage condition, or terminally ill).  “Interventions usually include: artificial Hydration, nutrition  administration of antibiotics, or other things that won’t necessarily make that person better or alleviate pain.

Of course, these are all issues, your Elder Law Attorney would be happy to discuss with you and do what we can to make sure your wishes are followed.

Posted by Andrew R. Boyer, Esq.

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