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Hi Charlie, like I said "Theres more than meets the eye here" I was quite aware of this case through the Canadian Press but thought others might be unaware of the "background"...... murray On 29 Jan 00 at 18:42, Charles T. Meyer, M.D. wrote: > Thanks for the additional information regarding Carol's opinion regarding > the case presented by Dennis Greene(for Ms. Spencer in Vancouver) for > consideration and comment. I read most of your references following your > posting and while I do not fundamentally differ from my original posting on > the subject I do have some concerns re the data that was presented for us to > consider. > > My concerns were basically related to the "fact" that we had been given > that there was little attempt to communicate with the patient which > apparently is untrue - he had been declared incompetent prior to the > incident of the refusal to give the DNR OK. Also that the wife did not > agree to the DNR order which I think takes precedence over the MD's idea of > what is best for the patient. The wife however certainly was inconsistent > by refusing the tracheotomy while also refusing the DNR order. A DNR order > is not an order not to treat just not to provide resuscitation if the > patient's heart stops beating or he stops breathing. > > I think this situation likely was caused by a poor doctor-patient-family > relationship and it wouldn't have come to trial if the doctors did not come > off in an arrogant way (see quotes from the MD in your bibliography). The > wishes of the patient when they conflict with the wishes of the patient and > the family must supercede those of the doctor. If he disagrees he should > offer to withdraw from the case before it comes to this point. Economics > should play little or no role in the decision. It is up to the MD to > understand where the patient or family is coming from and a little humility > will go a long way in bridging the gap. > > > Charlie ********************************************** You say " Economics should play little or no role in the decision." and while I agree it seems DNR orders CAN come down to an economic issue where judgement is swayed by ... Will these $$$$ best be spent to resuscitate a dying individual? or alternately... Will these $$$$ best serve those who cannot afford even basic care? It's never simple but you do need the whole story. Best regards ........... murray [log in to unmask]