DNR Order Mission Creep?

A Do Not Resuscitate Order (DNR), is not the same thing as a “do not treat” request, although there is sometimes confusion in that regard.  It simply means that if the patient has a cardiac arrest, the medical team (or nursing home personnel) are instructed to not try and revive the patient.  It is not the same thing as the patient stating, “I want to die now,” or “don’t do anything to keep me alive.”  It says, don’t give me CPR.

That is why an article in Medical News Today has me concerned.  It suggests that patients with a DNR be dissuaded  from receiving (or denied?)  life-extending surgery based on poorer outcomes for such people than those without DNRs receiving the same procedures.  From, “Should DNR Rules Apply to Life Prolonging Surgeries, Procedures?”

Could it be that if a patient has already decided to not continue their life by turning down resuscitation legally, healthcare professionals should save time and money by not recommending or performing surgeries to prolong life? A new study shows that about 70% of Americans die when they have do not resuscitate (DNR) orders in place, after having potentially saving surgeries or not…

Researchers contrasted the surgical outcomes for some 4,000 DNR patients with age-matched patients who’d had the same procedure done but didn’t have a DNR order. Overall, nearly 25% of DNR patients died in the month following their surgery, about three times as many as in the comparison group. That difference remained even after taking into account that DNR patients are usually sicker to begin with, Roman said, although the reasons aren’t clear.

So?  That means 75% didn’t die in that time, doesn’t it?

For those who would follow this very bad suggestion, consider this: I can’t think of anything that would more dissuade people from signing DNRs  than if they knew that by doing so, their doctors and/or bioethicists would henceforth consider other medical efforts to extend their lives not worth “the time and money.”  Good grief.

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