Q – I am the designated medical surrogate for an individual who has a living will specifying DNR/Do Not Resuscitate. The physicians and hospital have been informed and have copies of the living will and DNR. Our loved one took a downward turn but the medical team resuscitated him. The patient prospered from their efforts and returned to his pre-resuscitation health status. Should I report the medical team for ethical non-compliance of the DNR/living will orders?
A – I’ve consulted with a lawyer who is a specialist in this area and he said that yes, they should be reported. What they did was illegal and unethical, even if life was temporarily restored.
You have every right to chew the doctors out. They’ve caused a great deal of anguish to you and possibly to the patient, who may indeed have wanted what he instructed in the living will. But when your loved one signed the will, did he really know what he would feel at that moment when he was losing consciousness. During the instant when the fear of death suddenly became most real, did the legal document he may have signed long ago express his true wishes? Often, people sign living wills because, imagining the most horrible and hopeless situation (think Karen Ann Quinlan or Terri Schiavo), they don’t want to put their families through hell. A recent Pew survey indicates that about 35 percent of Americans have living wills, but according to my legal friend, many of have a change of heart later on.
So we need the kind of legal statement where the patients’ wishes can be balanced against other factors, like whether “heroic measures” would prolong a life of “quality” or simply prolong the agony of dying. Rabbis have developed Halachic Living Wills for just that purpose (see a full discussion from an Orthodox perspective here and two Conservative views here.)
The medical team was wrong, but if they were to err, better to err on the side of life. If your loved one was able to do something with the few extra days or weeks he gained, maybe one last “I love you” to a long lost relative, then the team’s error was for a blessing.
Rabbi Joshua Hammerman is spiritual leader of Temple Beth El in Stamford, CT. Read more Hammerman on Ethics here. Read his blog here
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