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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 thew 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 ----- Original Message ----- From: Murray Charters <[log in to unmask]> To: <[log in to unmask]> Sent: Saturday, January 29, 2000 3:52 PM Subject: Re: PD / cognative ability / and the law > On 29 Jan 00 at 11:36, Carole Hercun wrote: > > > My gut reaction is that this is a truly terrifying > > scenario. > > Every PWP's worst nightmare...that they will end up locked > > inside a body made of stone, while they are trapped inside > > kicking and screaming to get out and nobody able to hear > > them. Also, as a member of the medical establishment, I > > don't understand what's going on here. WHY are these > > doctors, nurses, etc. riding roughshod over this family's > > wishes? Ignoring ethical considerations, the situation > > doesn't even make sense as far as their lability is > > concerned, given today's litigious society. And this > > happened in CANADA? Carole > > > > Hi Carole, > This did indeed happen in Canada in the last coupla years.... It was > well covered by the media as it is sensational and controversial. It's > not quite as cut n'dried as Jack Kevorkian & Mike Wallace on 60 Min. > however.... > > We assume Dr's. training includes becoming familiar with applicable > living will statutes as well as the ethical issues surrounding > termination of life support, do-not-resuscitate orders, and informed > consent. We assume Dr's. training includes a review of current criteria > for the clinical diagnosis of brain death. > > Read these papers and think about it......... > > Do-Not-Resuscitate Orders Must Be Clear and Present - 1996 (USA) > http://news.medscape.com/jobson/MedTribNews/1996/sep/11/NoNotResuscitate > Orders.html > > Canadian Medical Association - Jan. 27th. '98 > Court verdict "splendid," ethics professor says... > http://www.cma.ca/cmaj/vol-158/issue-2/0159a.htm > > Canadian physicians now operate under a revised Code of Ethics 10/98 > http://www.cma.ca/cmaj/vol%2D155/issue%2D8/1148.htm > > Discussion Paper on this particular case courtesy of > The Centre for Renewal in Public Policy > http://www.centreforrenewal.ca/lex-23.html > > News Archive - Nov. 13th. '98 > http://www.canoe.ca/NewsArchiveNov98/candigest_nov13.html > Judge lifts do-not-resuscitate order -- for now Scroll down to.... > WINNIPEG (CP) -- A judge has lifted an involuntary do-not-resuscitate > order doctors put on a 79-year-old man in a Winnipeg hospital. > > The Manitoba League of Persons with Disabilities (MLPD) Feb. '98 > http://www.pcs.mb.ca/~ccd/lw12298.html > > Manitoba League MLPD speaks out....... Dec. 23rd. '98 > http://www.pcs.mb.ca/~ccd/lw231298.html > > Provincial Health Ethics Network reprint... > This article first appeared in the Winnipeg Free Press - Nov. 18 '98 > http://www.phen.ab.ca/materials/intouch/vol2/intouch2-01.html > > Death in Winnipeg - from the Fraser Institute... > http://www.fraserinstitute.ca/publications/forum/1999/01/death.html > > Canadian Medical Association - March23rd. 1999 > http://www.cma.ca/cmaj/vol-160/issue-6/0869.htm > > Ethics in Law > Scroll down to: When Can Physicians Say No? > http://www.google.com/search?q=cache:cpa.medical.org/pubs/bulletin/featu > res.htm > > Winnipeg DNR man goes home - July '99 > http://www.lifesite.net/interim/1999/july/acrosscanada.html > > Canadian Bioethics Report, August 1999: Court Decisions > Scroll down to: Sawatzky v. Riverview Health Centre Inc. (Update) > http://www.cma.ca/cbr/aug99/court.htm > > I recall reading of Mr. Sawatsky's death late in the fall of 1999 > > Carole, there's a lot more here than meets the eye......... > > regards ............. murray > > [log in to unmask]