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Monday, July 19, 2010

Why "do not resuscitate" might not be the right words


As part of comprehensive estate planning, most people will have a Personal Directive (also called Health Care Directive, Advance Directive, or Health Care Proxy, depending on where you live) prepared for them. A Personal Directive appoints someone to be your decision-maker and spokesperson on health, medical and personal decisions if you should lose your ability to make those decisions for yourself.

When I am meeting with clients about these documents, they often tell me that they want a document that says "DNR" or "Do Not Resuscitate". Most of the time, people are quite confident that this is exactly what they want, but it almost never is.

What they want to express is that if they are in a vegetative state and if higher functioning cannot ever be restored no matter what is done, they don't want to be kept alive artificially.

Unfortunately, that's not what DNR means.

What if the person who wouldn't want to be kept alive artificially if in a vegetative state is not in that state but is healthy. What if he or she has, say, a heart attack or stroke. He or she would most likely want to be resuscitated as the incident has nothing to do with a vegetative state. He or she could be expected to recover from a heart attack or stroke, if not completely then certainly well enough to carry on a happy life for many years. But not if their document says DNR.

DNR is a blanket instruction that would apply to all situations, not just the vegetative state. DNR means not to revive the person at all. Ever. When this is explained to people who have just told me they want DNR in their documents, they are sometimes quite shocked that they almost instructed the exact opposite of what they want.

If you have documents in place right now that include a DNR instruction, think about what that could mean for you, and consider whether it's what you really intend. I've spoken to a number of doctors who see these DNR documents in hospitals who say they agree with me that the people signing them did so without having any idea of the consequences.

When you're not able to speak for yourself, words matter. Make sure yours are the right ones. It's worth the time and money to get your document done properly so that there are no unintended outcomes.

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