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  1. #31
    Join Date
    Dec 2017
    Quote Originally Posted by MLadyEm View Post
    NOK can still override a DNR. If they’re in the room when the person dies (or at least nearby) and they say “resuscitate”, you have to do as they wish, and you can’t just do a half hearted effort. It has to be a full blown resus until direction comes to stop. It is a traumatic experience for everyone involved.

    You just have to hope that the patient has had the conversation with their family about it (much like organ donation) so the family understand the wishes of the patient and respect them.
    This is not exactly true. If a patient has an advanced care plan stating NFR (DNR) this legally cannot be overriden by family.

    Medical professionals also have overriding authority over loved ones (and patients for that matter). If they deem it inappropriate, they can decide not to resuscitate a person. Obviously, it is very complex and ideally everyone should be on the same page.

    Many organisations, when any person is admitted to hospital, will discuss goals of care (which if appropriate includes NFR status). It has made talking about death more open and comfortable, it encourages conversations and if alerts people to the options of advance care planning.

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    Mrs Tickle (03-07-2018)

  3. #32
    Join Date
    Jun 2014
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    Quote Originally Posted by Californication View Post
    WOW, really? I did not know that. I knew organ donation could be over ridden, but thought a DNR was final. Nice to know I actually don't have any rights to decide what happens to me!

    that's awful. I understand she may not have been ready for him to go, but I'm a big advocate of people being able to decide how they go out if they have an illness they won't recover from, whether that's euthanasia or a DNR. My grandmother had a stroke and after seeing her suffer for over a decade, I wished they hadn't found her and she'd just slipped away. It would have been an awful shock for us, but so much kinder for her. I know she wished it too. She asked me to end her life a few times and I wish I'd have been able to do it for her.
    I couldn’t agree with you more. Being exposed to it makes me certain what I would want if I was at the end of my life.

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    Californication (28-06-2018)

  5. #33
    Join Date
    Aug 2013
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    @Californication yep. It’s all to do with legalities and risk of being sued etc. Thankfully it doesn’t happen often. Usually it’s because the relatives aren’t prepared for the reality of death and the finality of it all. The one instance I know of it happening (in my former life as an oncology nurse), the consultant was called in to speak to the family and basically try to express to them that resuscitation actually wouldn’t achieve the outcome they were hoping for. In the private setting it’s not common for the consultants to come back to the ward after they’ve done their daily round unless someone is sick, so it was impressive that a)he came when rang (and didn’t leave the conversation to the ICU team) and b)came quickly.

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    Californication (28-06-2018),Mum-I-Am (28-06-2018)

  7. #34
    Join Date
    Jul 2011
    Achievements:Topaz Star - 500 postsAmber Star - 2,000 posts
    This is a tricky one for me. My mum has kidney cancer, initially it was encapsulated and she had the affected kidney removed. She now has about 3/4 of the remaining kidney after they found growths there, there was talk of removing the entire kidney and putting her on dialysis. She is not eligible to go on the transplant list because she has cancer so it would be a life on dialysis, she almost had it removed 3 years ago. After they decided against it they found that she already had growths in other areas so removing the remainder of her kidney was unnecessary. Just facing the reality of a life on dialysis made me go and register my name on the organ donor register.

    My mum was the reason I hadn’t done it before. When I was 17 and getting my license my mum told me she couldn’t agree to organ donation, it made her uncomfortable and even though she mentioned she knew her extended family would be disappointed as her cousin had received an organ as a young woman she was not a donor. Being young and thinking I’ve got time to decide I didn’t tick the box either. I’m glad I’m able to now make that decision, and with my mums experience I think she is now ok with that. I would hope she would follow my wishes. She obviously is not able to donate herself with her cancer, given the uncertainty we’ve faced in the past 12 years with believing it was encapsulated in the kidney, to lung, to more kidney, to spine, to leg it would be just too uncertain about the presence of cancer.

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    BettyV (29-06-2018)

  9. #35
    Join Date
    Apr 2014
    Quote Originally Posted by BettyV View Post
    This is a really personal topic for me as I have a sibling on the transplant list. Our family will be devastated if we lose him. I’m pretty sure if it got to the point of certain death or organs that pose the risk of cancer developing, we’d be begging him to consider the cancer option. That being said, I still think increasing the number of organs available by getting people to register and talk to their families is a far better move than moving on to less “perfect” (for want of a better word) organs. It breaks my heart to hear people say they wouldn’t donate their own or a loved ones organs. Especially given the extremely limited situations where organ donation is even plausible. Why not bring something good out of a tragedy?
    I reserve my judgement. For many people, be it for cultural, religious or other reasons, donation is not an option for them. For them, donation is a violation and not a good outcome and they have a right to that opinion.

    Regarding a DNR, the final word is with medical staff. Relatives cannot override.

    With regards to one's wishes when dying, make sure you have an Advanced Care Directive in place whereupon you appoint a Substitute Decision Maker to carry out your wishes. That way, you can be assured that what you say goes and not what your relatives want. This goes for organ donation, DNR orders, the lot. Once you square that away, nobody can walk in and change what you want when you're incapable of doing so.


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