My client, Ms. H sat in my office with tears in her eyes. She had cared for her elderly mother for years as she suffered from Alzheimer’s disease. But before her mother had become incoherent from this horrible disease, she had told her that when her time had come, she did not want to be resuscitated and have her life extended with invasive medical intervention. In short, she wanted to die a natural death. To protect this promise to her mother, Ms. H obtained for her a do not resuscitate order (DNR), signed by her mother’s physician. This order is authorized under Florida law. In fact, there is a specific form created by the Florida Department of Health. It is to be used in every case where a person wants to die a natural death, free from invasive medical intervention to artificially prolong life.
When her mother was taken to a Central Florida hospital to be treated for a urinary tract infection, Ms. H made sure that the order was signed and that the nursing staff was aware of it. When her treatment was complete, Ms. H’s mother was transferred to a rehab facility. Unfortunately, the hospital failed to include the DNR order in the transfer records. Compounding this negligence, the rehab hospital did not assess her end-of-life wishes and arrangements. Ms. H had faith that the health care professionals would have taken care to make sure that her mother’s DNR status was noted in the patient chart. Unfortunately, she was wrong.
After the fourth day of admission, Ms. H’s mother stopped breathing. Unaware of her DNR status, the nurses summoned EMT’s and ordered that the patient be transported to the hospital. Performing their duties unaware of the DNR order, the paramedics resuscitate their frail 91-year-old patient by performing CPR, cutting a hole in her throat to create a breathing tube and injecting her with medications that stimulated her heart to beat. After arrival at the hospital, the patient was forcibly intubated and then transferred to the intensive care unit.
For five agonizing days, Ms. H tried to decide what to do. She knew that her mother did not want the artificial life support that was keeping her alive. Yet, to make the decision to withdraw that support seemed like an unbearable burden. Finally, she authorized the hospital to disconnect her mother from the ventilator and let her die the way she wanted.