The “do not resuscitate order” (DNR) is an important part of medicine that allows terminally ill, injured, and very aged patients die naturally without intrusive and potentially injurious efforts to keep the heart beating.
In short, the DNR informs a medical team faced with a patient in cardiac arrest to stand down.
Since it involves life and death, in this country (unlike the UK), DNRs are supposed to be only put on a chart with consent. But as medicine grows increasingly technocratic, we see doctors or bioethics committees placing them on charts without consent–perhaps without discussion–with family or patient.
In the UK–the mother of all technocratic medical systems–non voluntary DNRs have become something of a scandal. From the BBC story:
A “do not resuscitate” (DNR) order means medical staff will not attempt to bring the patient back to life if they stop breathing or their heart stops. The decision to use one is ultimately a doctor’s, but guidelines state medical staff have a duty to discuss it with relatives wherever possible.
The study of just over 9,000 dying patients, taken from cases in May 2015, found that in 81% of cases where a DNR was in place, a senior doctor did discuss the decision with a family – up from 72% in a 2013 audit. In 16% of cases the decision was not discussed with relatives. In the other 4% of cases records showed there were no relatives or the family could not be contacted.
Extrapolation from the 9,000-strong sample suggests thousands of people have had DNRs put in place without their family’s knowledge.
Don’t think that can’t happen here. It already does.
It isn’t just the DNR itself. There is anecdotal evidence that a DNR on a chart can lead to other treatments being withheld, despite the fact it is supposed to only apply to cardiac arrest.
Pertinently, some of the most influential architects of Obamacare looked to the NHS as their model of centralized control.
When you have centralized control, you get check-list medicine rather than individual care–sometimes with lethal results, as in this story and the Liverpool Care Pathway backdoor euthanasia scandal.