Dear Grandma, Aren't You Ready to Die Yet?
We can't have expensive old people hanging around using up resources (that their enterprise and hard work helped generate!). So the bureaucratic-controlled National Health Service in the UK wants doctors to ask every elderly person -- healthy or not -- whether they want a DNR (do not resuscitate) order put on their chart. From the story in the Daily Mail:
Doctors are being told to ask all patients over 75 if they will agree to a 'do not resuscitate' order.
New NHS guidelines urge GPs to draw up end-of-life plans for over-75s, as well as younger patients suffering from cancer, dementia, heart disease, or serious lung conditions. They are also being told to ask whether the patient wants doctors to try to resuscitate them if their health suddenly deteriorates,
The NHS says the guidance will improve patients' end-of-life care, but medical professionals say it is 'blatantly wrong' and will frighten the elderly into thinking they are being 'written off'.
In some surgeries, nurses are cold-calling patients over 75 or with long-term conditions and asking them over the phone if they have 'thought about resuscitation'.
Good grief! A DNR is an "allow to die" order in the event of a cardiac arrest. It should only be signed when one understands the specific circumstance under which it would be applied.
And don't tell me there won't be some "persuasion." It's like the dinner guest who overstays his welcome and the host looks at her watch and asks how long a drive it is to get home.
The NHS is a socialized system, but it is relevant to us because of the aspect of centralized control. Don't be surprised if one day U.S. doctors receive just such a memo, given the current direction of things. And don't forget that one prominent Republican presidential candidate has already called for mandatory signing of advance medical directives for everyone on Medicare.
Not yet, but one day -- unless we smarten up and dismember the growing federal power over standards of care.