Do Not Reconsider, II

On the whole it's a salutary thing for all health care workers to think about their patients' wishes when it comes to resuscitation and intubation. But selection bias is a killer. What I mean is that doctors start getting curious about DNR/DNI orders when their patients get very sick. Since no one thinks to ask about these orders when the patients are relatively healthy, you could be forgiven for thinking that on occasion these orders, rather than a way in which a hospital interprets a patient's wishes, are an acceptable method of declaring medical futility. But that's a big problem - you don't want these categories to be mixed up. (And, of course, any competent doctor would I'm sure be horrified at any suggestion that this is what she's doing, since - in fact and in law - there's a lot that can be done in terms of medical treatment that has nothing to do with resuscitation or intubation.) The solution, of course, is to have everyone's DNR and DNI status stamped on their foreheads the minute they're seen by their first doctor. Not only is this not happening, I even wonder if it could. If informed consent is laughable in its practical execution, what more can one expect from DNR/DNI?

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