October 26, 2007
Terminally ill people often add advanced directives to their Health Proxies to inform medical personnel about what kind of care they want for themselves in medical emergencies and at different stages of their lives. Since Living Wills are not statutorily recognized in Massachusetts, Do Not Resuscitate (DNR) and Do Not Intubate (DNI) documents are extremely important parts of an individual's health care planning and Health Proxy in the Commonwealth.
These documents speak when one is incapable of voicing his or her own wishes as to medical care and procedures, and they ensure that no extraordinary lifesaving measures are taken to prolong life when a certain quality of life cannot be assured. The degree of quality of life acceptable to an individual is a personal issue, so it is best considered by individuals on their own.
More importantly, whatever the health care decision, it needs to be communicated in a way that it will be recognized and followed by health care providers. It is important to understand that cardiopulmonary resuscitation (CPR) can be withheld under only two circumstances: (1) when CPR is judged to be of no medical benefit and (2) when an individual with an intact decision-making capacity or someone designated as the decision- maker, clearly indicates that CPR is not wanted.
The first circumstance occurs when it is clear that there is no clinical benefit to CPR. The second circumstance depends on a previous decision made by the patient. These issues are complicated when tragedy strikes a healthy person who does not have a Health Proxy. Without advanced directives to guide medical personnel,...
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by: Julie A. Dialessi-Lafley, Esq.