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Orders Not to Resuscitate: Dilemma for Acute Care as Well as Long Term Care Facilities

Published online by Cambridge University Press:  27 April 2021

Jane Greenlaw
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Abstract

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Type
NLE Rounds
Information
Law, Medicine and Healthcare , Volume 10 , Issue 1 , February 1982 , pp. 29 - 45
Copyright
Copyright © American Society of Law, Medicine and Ethics 1982

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References

But see Brown, N.K. Thompson, D.J., Nontreatment of Fever in Extended Care Facilities, New England Journal of Medicine 300:1246–50 (May 31, 1979).Google ScholarPubMed
In re Quinlan, 355 A.2d 647 (N.J. 1976).Google Scholar
Superintendent of Belchertown State School v. Saikewicz, 370 N.E.2d 417 (Mass. 1978).Google Scholar
For an indepth discussion of these two cases, see Annas, G.J., Reconciling Quinlan and Saikewicz: Decision Making for the Terminally Ill Incompetent, American Journal of Law & Medicine 4(4):367 (Winter 1979). The highest court in New York has recently decided two cases together without citing either Quinlan or Saikewicz. Eichner holds that an incompetent patient in New York does have a right to refuse treatment by a prior declaration made when he was competent. Storar uses a mechanical view of prior blood transfusion cases to require that transfusions be given to a mentally retarded, terminally ill patient. In re Storar, 420 N.E.2d 64 (N.Y. 1981). For discussion, see Annas, G.J., Help from the Dead: The Fox and Storar Cases. Hastings Center Report 11(3):l9–20 (June 1981).Google ScholarPubMed
In re Dinnerstein, 380 N.E.2d 134 (Mass. App. 1978).Google Scholar
Id. at 139. See also, Glantz, L.H., Post-Saikewicz Judicial Actions Clarify the Rights of Patients and Families, Medicolegal News 6(4):9 (Winter 1978).Google ScholarPubMed
In re Spring, 405 N.E.2d 115 (Mass. 1980) (emphasis added).Google Scholar
See. e.g., Do Not Resuscitate (DNR) Guidelines, Minnesota Medical Association, Approved January 24, 1981.Google Scholar
This is consistent with recently updated standards. See Standards for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiac Care (ECC). Journal of the American Medical Association 244(5):453–509 (1980).Google Scholar
This was the approach adopted by the court in Dinnerstein. supra note 5, at 139, n. 10.Google Scholar
In the one known case where an active DNR order was challenged, the order was struck down because the guardian of the incompetent patient did not clearly understand its significance. Hoyt v. St. Mary's Rehabilitation Center. No. 774555, (Dist. Ct., 4th Jud. Dist., Hennepin Co., Minn. February 13, 1981). See Annas, G.J., Orders Not to Resuscitate: The Sharon Siebert Case, Nursing Law & Ethics 2(5):3 (May 1981).Google Scholar
See, e.g., Petition of J ones. 433 N.Y.S.2d 984 (N.Y. 1980). In some states, the definition of brain death as legal death is contained only within organ donation statutes, and this has caused some confusion about the pronouncement of death. See, Bacchiochi v. Johnson Mem. Hosp., No. 256126 (Super. Ct., Hartford/New Britain, Conn., March 13, 1981) (physician refused to withdraw respirator from brain dead patient who was not an organ donor).Google Scholar
In re Spring, supra note 7.Google Scholar
Commonwealth v. Capute. Bristol County Super. Ct., Massachusetts, October 22, 1981, Nos. 6828 (murder charge) and 6829 (unlawful dispensing of controlled substance).Google Scholar