The Advance Directive Said DNR, But....

A crowd of various medical staffers quickly gathered in the small room where an elderly man, Mr. R, had unexpectedly lost his pulse while undergoing a CAT scan. For several minutes, the patient endured multiple rounds of rib-breaking thrusts to his chest to restart his heart. Then, suddenly, a nurse who had been reading through his medical chart screamed, “This man has an advanced directive from six years ago that says he does not want resuscitative measures!” Nearly all the heads in the room turned, many staffers confused as to whether to continue the resuscitation. The advanced directive is a legal document that records a patient’s preferences for medical care in case communicating them is impossible. In most cases, a "do not resuscitate" order alone might stop a medical team from pursuing further intervention. But this man, unlike many patients in the intensive care unit who were clearly close to dying, had walked into the hospital for an elective diagnostic work-up. As of that morning, he was not close to dying, and even within moments of starting CPR, we felt reasonably certain that we could resuscitate him....He walked out of the hospital two days later, knowing that he had almost died. What he did not know was that aside from his heart stopping, he'd come one step closer to death because of a lack of clarity in his code status, which easily could have resulted in us stopping our efforts to revive him.