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IMHO, one of the greatest problems with advanced directives/living wills is how generic they are....."if I have a terminal condition...." I developed one that is scenerio or diagnosis specific and I have given it out to over 600-700+ people. If anyone would like a copy by email just let me know. Most are difficult to interpret as we saw in an above post...DNR comes in many flavors and as the doc reading and trying to understand what the patient wants without the luxury of discussng it with the patient while they are rational, calm, mentally able, I have to read them and try to understand what they meant by their generic DNR or adavanced directive or living will. Usually, families are less than capable or helpful with the interpretation.
There is never an excuse for a health care provider to not know the status (DNR, DNI) of a patient. This is where the wrongful life suit comes into play. They have to know, whether by arm band, chart label/sticker, or what ever means that particular hospital uses, but if a patient is wrongly resuscitated, there should be hell to pay because you have crossed the line of patient trust in their health care providers. We always want to do what is asked of us (if it is reasonable) to fulfill a trust that the patient has in us, we (I) never want to violate that trust, it is too sacred.
ss
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'Revel in action, translate perceptions into instant judgements, and these into actions that are irrevocable, monumentous and dreadful - all this with lightning speed, in conditions of great stress and in an environment of high tension:what is expected of "us" is the impossible, yet we deliver just that.
(adapted from: Sherwin B. Nuland, MD, surgeon and author: The Wisdom of the Body, 1997 )
Education is the anti-ignorance we all need to better treat our patients. ss, 2008.
The blade is so sharp that the incision is perfect. They don't realize they've been cut until they're out of the fight: A Surgeon Warrior. I use a knife to defend life and to save it. ss (aka traumadoc)
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