Do not Resuscitate orders

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I have a question about DNR orders and how, if at all, they fit in with Catholic theology. My grandmother is in the last stages of Alzheimer’s disease and has hospice care that comes to my mother’s home to care for her. The hospice has asked my mother about DNR orders and then my mother asked me. I really don’t know what to recommend. On the one hand, I know when God is ready for her, then she will pass away no matter what is done to try to keep her alive and on the other hand she is sufferring so much and I don’t know how painful the rescue efforts could be to her. I need help in how to direct my mother.
 
I think they are fine for someone old and ready to go. In a Catholic nursing home that I am familiar with, they do not want to rescusitate these elderly folks who are ready to go. They said that the process can break their ribs and that it is a terrible thing to put them through. I think it is considered extraordinary and unnecessary. It would probably be a different story for a young person who had been in an accident.
 
DNRs are permissable under Church teaching when the person is terminal. My mother was placed in hospice care earlier this year with terminal lung cancer. We had a DNR order because it was explained to us that if we didn’t have one in writing and EMS was called out they would be required by law to try to resuscitate her even though she was terminally ill. Priests for Life has information on their website about Church teaching on end of life issues which I consulted when my mother was dying. I am 100% pro-life and didn’t want to make any life decisions contrary to that.
 
I agree with Listener. (EDIT: and veritas41 we were posting at the same time.) I was in the exact same situation as the OP in 2003. My grandmother had late stage alzheimer’s and we struggled with the decision for the DNR. My mom is an only child and really weighed the facts. She got (name removed by moderator)ut from my grandmother’s sisters. They are also active Catholics faithful to Church teaching. They helped put my mom at ease with her choice. It was hard to walk in her room and see that DNR framed on her wall, but we knew it was best.

As it turned out her death was very peaceful, with my mom and me, both at her side. She received full annointing and died with dignity. She had begun refusing food for about a week and had all signs of being close to death. She was hydrated with water drops and given oral morphine for pain. The hospice nurses were fabulous.
 
If the person is dying and near death, many times it would be appropriate to have a DNR order. This is okay for a Catholic to do in those situations.

If you are concerned that there is something unusual in the situation, consult a priest so you will feel comfortable about your decision.
 
A general rule of thumb is that it is morally permissible to refuse treatment if the treatment itself is unbearable or overly burdensome (physically, psycologically and I have even heard in economic reasons, but I would hope that would be last resort type of things), not because the individual despairs about life. This includes DNR’s as permissible. Also in some instances at the end of life refusing food is acceptable (JP2 in his statement was more referring to people who can normally digest such as Terri Schiavo) because as it turns out, the food does more harm and they cannot properly digest it (some people worry you are starving them to death, but near death patients are better off not having food, just palliative care to treat pain and also stuff to keep hydrated). Hope that helps.
 
Good responses I think. It is all about dignity and what is “right and fitting”. As a nurse, I can see the sense in discussing DNR orders with members of the family of the ill person to ascertain how they feel about their loved one. By precluding heroic efforts but all care up to but excluding what ever is always worth discussing. If the person is in a fit state to discuss their desire to have a good death so be it.

On the other hand it should never have aspects to hurry along a persons death as its primary concern

I have added you to my prayers at this difficult time for you and your family.
 
Dear all,
You do not need to be near death to sign a DNR order. And it is OK with the church. The DNR order can include a section that if something should happen, and the hope of returning to a quality life is poor, then do not resuscitate. This could be true for severe stroke and/or heart attacks. But don’t forget the maiming accident too. Most diseases give us time to act after diagnosis. The ones listed above and a few others don’t.
 
********Thank you all for taking the time to help my mother and myself with this. It is a very difficult time and decision. It really is heartening to know that there is a place, this forum, and people that care, it means a lot.
May the Peace of the Lord be with you all,
 
NEVER sign a DNR order. It is an excuse for medical personnel to deny a patient any and all medical treatment.
 
epower said:
NEVER sign a DNR order. It is an excuse for medical personnel to deny a patient any and all medical treatment.
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One can set up a durable power of attorney and appoint a person you trust to make decisions for you when you are not conscious.
 
There comes a time in the course of an illness when you are no longer prolonging life but merely prolonging death. A DNR order in late-stage, irreversible, terminal illness is not contrary to the Rule of Life.
 
mercygate said:
There comes a time in the course of an illness when you are no longer prolonging life but merely prolonging death. A DNR order in late-stage, irreversible, terminal illness is not contrary to the Rule of Life.
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We went through this last year. My dad was 83 when he died. He had about 10 strokes, only about 3 of which were serious, in the last 8 years of his life. His eyesight was very poor, his mobility was minimal, and he had Parkinsons. They discovered a cancerous tumor on his colon. After the operation, we had to send him to a nursing home to recover. After about 10 days there, they sent him back to the hospital with a fever and a clogged feeding tube in his stomach.

They determined that he had a major infection of the stomach and that they had to operate or else he would certainly die. When they removed as much of the infected material as they could, they noticed the top quarter of the stomach was perforated and he had a bleeding ulcer underneath. The patched it up as best they could.

He never regained full consciouness as best we could tell and he died about 5 days after the stomach operation. My mother was with him for about three minutes that Monday morning when he stopped breathing. We had established a DNR order. If they attempted to revive him, it is possible that he could have recovered and lived another year or two. But all he would have to look forward to is a year or more of being bedridden and senile.

In this case, we could have gone out of our way to squeeze a few more years out of him, but at a certain point - one has to let go for the sake of the afflicted. Who wants to live as long as possible with a major affliction? Is it proper to let someone endure every exquisite pain cancer, parkinsons, or alzhiemers can inflict?

I think people lose their perspective regarding death. Death is a blessing and a remarkable spiritual journey back to God.

I think the first thing I will exclaim in the second life is: “No more trips to the dental chair! Hallelujiah!!!”

Thal59
 
Thal59 said:
We went through this last year. My dad was 83 when he died. He had about 10 strokes, only about 3 of which were serious, in the last 8 years of his life. His eyesight was very poor, his mobility was minimal, and he had Parkinsons. They discovered a cancerous tumor on his colon. After the operation, we had to send him to a nursing home to recover. After about 10 days there, they sent him back to the hospital with a fever and a clogged feeding tube in his stomach.

They determined that he had a major infection of the stomach and that they had to operate or else he would certainly die. When they removed as much of the infected material as they could, they noticed the top quarter of the stomach was perforated and he had a bleeding ulcer underneath. The patched it up as best they could.

He never regained full consciouness as best we could tell and he died about 5 days after the stomach operation. My mother was with him for about three minutes that Monday morning when he stopped breathing. We had established a DNR order. If they attempted to revive him, it is possible that he could have recovered and lived another year or two. But all he would have to look forward to is a year or more of being bedridden and senile.

In this case, we could have gone out of our way to squeeze a few more years out of him, but at a certain point - one has to let go for the sake of the afflicted. Who wants to live as long as possible with a major affliction? Is it proper to let someone endure every exquisite pain cancer, parkinsons, or alzhiemers can inflict?

I think people lose their perspective regarding death. Death is a blessing and a remarkable spiritual journey back to God.

I think the first thing I will exclaim in the second life is: “No more trips to the dental chair! Hallelujiah!!!”

Thal59
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Ahh. I, too, faced this with my father. While it is certain that you do not kill people, it is equally certain that sticking ventilator tubes down people’s throats, launching painful surgeries, running drains and such are exercises against the inevitable. Death IS an enemy. But when it becomes clear that it cannot be forestalled without inflicting pain that will not yield good fruit, then it is time for the virtue of faith to supercede the virtue of hope and stop the stupidity.

When my time comes, I will look forward to never having to fill out another IRS form.
 
You and your family are in my prayers. I lost my husband in January, I had to decide about a DNR. It was very difficult. I think it’s about what becomes extraordinary to save life. They did all they could for my husband. He was on a feeding tube, and on a ventilltor. He could not live off the vent. He had barely survived a stomach aneurysm only to find out he had advanced stages of lung cancer. My heart goes out to you and your Mom.

From the Catechism 2278:
Discontinuing medical procedures that are burdensome, dangerous, extraordinary, or disproportionate to the expected outcome can be legitimate; it is the refusal of “over-zealous” treatment. Here one does not will to cause death; one’s inability to impede it is merely accepted. The decisions should be made by the patient if he is competent and able or, if not, by those legally entitled to act for the patient, whose reasonable will and legitimate interests must always be respected.
 
epower said:
NEVER sign a DNR order. It is an excuse for medical personnel to deny a patient any and all medical treatment.
Click to expand...
I don’t think that’s true. They only do not resusitate…they do everything else in their power to keep them alive .
 
epower said:
NEVER sign a DNR order. It is an excuse for medical personnel to deny a patient any and all medical treatment.
Click to expand...
That is absolutely not true.

A DNR order for a patient means that the only thing you don’t do is start CPR and ACLS (advanced cardiac life support). Everything else, IV fluids, pain medication, etc, are continued.
 
becka01101 said:
That is absolutely not true.

A DNR order for a patient means that the only thing you don’t do is start CPR and ACLS (advanced cardiac life support). Everything else, IV fluids, pain medication, etc, are continued.
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Not necessarily. Sometimes they are interpreted as not doing anything for the patient if they cannot do it for themselves. Things such as drinking, for instance. I thought what was quoted above was true, also, until my FIL had a stroke and could not swallow.
 
katy said:
Not necessarily. Sometimes they are interpreted as not doing anything for the patient if they cannot do it for themselves. Things such as drinking, for instance. I thought what was quoted above was true, also, until my FIL had a stroke and could not swallow.
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The standard of practice is only to withhold CPR and ACLS. The rest is up to what the patient has set ahead in writing, or what the physician and family decide is appropriate. Healthcare practitioners cannot independently decide to withhold care, such as fluids, outside just because the patient is DNR.
 
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