Guest guest Posted July 22, 2004 Report Share Posted July 22, 2004 When in doubt, work the patient. I would rather be on trial for helping someone than neglecting to help someone. In my protocols it states (paraphrasing of course) if ONE family member says to do CPR, the DNR is revoked and CPR is to be continued even if there is a living will, advanced directive, or State of Texas DNR. The protocol is plain and simple, work the pt if the family objects to stopping CPR. D. Stone Supervisor wrote: I've sent this out before, but received very little input other than a few opinions. Does anyone have any factual info? If a person signs a DNR while they are competent and able to make reasonable and informed decisions about their healthcare, can a family member or POA revoke or rescind that DNR later in the person's life when they are deemed to be incompetent or unable to decide for themselves? Bullard BS, LP Training Coordinator Lubbock Aid Ambulance Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 22, 2004 Report Share Posted July 22, 2004 When in doubt, work the patient. I would rather be on trial for helping someone than neglecting to help someone. In my protocols it states (paraphrasing of course) if ONE family member says to do CPR, the DNR is revoked and CPR is to be continued even if there is a living will, advanced directive, or State of Texas DNR. The protocol is plain and simple, work the pt if the family objects to stopping CPR. D. Stone Supervisor wrote: I've sent this out before, but received very little input other than a few opinions. Does anyone have any factual info? If a person signs a DNR while they are competent and able to make reasonable and informed decisions about their healthcare, can a family member or POA revoke or rescind that DNR later in the person's life when they are deemed to be incompetent or unable to decide for themselves? Bullard BS, LP Training Coordinator Lubbock Aid Ambulance Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 22, 2004 Report Share Posted July 22, 2004 I'll try to guide y'all through an analysis of this. Scroll down. Gene G. In a message dated 7/22/2004 2:50:31 PM Central Daylight Time, supervisor@... writes: I've sent this out before, but received very little input other than a few opinions. Does anyone have any factual info? If a person signs a DNR while they are competent and able to make reasonable and informed decisions about their healthcare, can a family member or POA revoke or rescind that DNR later in the person's life when they are deemed to be incompetent or unable to decide for themselves? Go to this site and look at the form, and it will explain the procedures clearly. http://www.tdh.state.tx.us/hcqs/ems/dnr.pdf The patient may execute the DNR at a time when he is mentally competent (an incorrect term--the patient must possess " present legal capacity " as well as being legally mentally competent. Loose language has been an ongoing problem with these issues). If the patient is lacks the capacity to execute the DNR, it may be executed by anyone who has the legal right to make such a determination under the law, which is found in the Texas Family Code for Texas patients. If there are no patient surrogates available or they do not want to act, two physicians may execute the document. The DNR may be revoked by ANY of the persons qualified to execute it. Therefore, it a patient has executed a DNR at a time when he had present mental capacity and legal competence, but later becomes incompetent, any of the surrogates may revoke it. This is spelled out in detail on the back of the official DNR form. Best, GG Bullard BS, LP Training Coordinator Lubbock Aid Ambulance Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 22, 2004 Report Share Posted July 22, 2004 Please folks, read the law. It is readily available for all to read and see for themselves what it says. The official DNR form is available on the TDH BEM site, and it contains detailed information about how it works. Or, better still, read Chapter 166 of the Texas Health and Safety Code. It can be found at http://www.capitol.state.tx.us/statutes/docs/HS/content/htm/hs.002.00.000166.00.\ htm#166.001.00 Chapter 166 spells out ALL the possible advance directives and how they work. As Mike correctly says, protocol does not override state law. You are bound to follow state and federal law no matter what your protocols say. So read the law and inform yourself. I do not mean to criticize anyone with this comment. Finding the law is difficult sometimes even for lawyers. However, often folks who have questions about legal questions haven't tried to find the applicable regulations because they really do not know how to do it. So here's my recipe for research. Go to Google.com and put in some words that describe what you're looking for. In this case, I used " Texas Out of Hospital Do Not Resuscitate " and I was immediately taken to the BEM site and also the Health and Safety Code reference. It helps if you have a working knowledge of where law is found. In Texas, all the laws that govern EMS services are found in the Texas Health and Safety Code. Most of them are in Chapter 773. But even if you don't know that, Google will take you there. So before asking the list for advice, try to find the answer yourself through Google. It will save you a lot of time and result in your finding the REAL answers rather than the opinions of us list trolls. Not that we're either right or wrong. But when you can find the law and read it for yourself, you're better off. As Billie Holliday sang, " God Bless The Child That's Got His Own. " Bottom line for OOH DNRs: If somebody says " We want everything done, " do it. Of course, there are zillions of variable scenarios that may come into play at the scene of a full arrest, including coded patients that we know and have worked on multiple times and may have a mindset about what should be done that's skewed, forged DNRs, people pretending to be family members who have in fact just killed the patient with injections of lead or more subtle agents; family members who disagree about what should be done, and people who have no legal relationship to the patient but who are screaming DO SOMETHING and you don't have a clue who they are, what their legal status is, or why they're there. So when in doubt, work them. There have been no successful cases based upon wrongful resuscitation that I am aware of. People have sued for wrongful resuscitation, but to my knowledge there hasn't been a case where anybody was held liable for not following an OOH DNR when there were questionable circumstances. If anybody knows of such a case, please immediately let me know about it. Best, GG In a message dated 7/22/2004 7:40:49 PM Central Daylight Time, hatfield@... writes: I disagree. Protocol does not override state law, or personal choice (exception given to extenuating circumstances), 'because my protocol said so' is no defense. Albeit a rare occurrence, this situation, at best, will be one for a phone call to your Medical Director, or online medical control. When brought this up the first time, I don't think we got a clear answer to it, and like him, I am still curious. Mike From: Donnie Stone When in doubt, work the patient. I would rather be on trial for helping someone than neglecting to help someone. In my protocols it states (paraphrasing of course) if ONE family member says to do CPR, the DNR is revoked and CPR is to be continued even if there is a living will, advanced directive, or State of Texas DNR. The protocol is plain and simple, work the pt if the family objects to stopping CPR. D. Stone If a person signs a DNR while they are competent and able to make reasonable and informed decisions about their healthcare, can a family member or POA revoke or rescind that DNR later in the person's life when they are deemed to be incompetent or unable to decide for themselves? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 22, 2004 Report Share Posted July 22, 2004 Please folks, read the law. It is readily available for all to read and see for themselves what it says. The official DNR form is available on the TDH BEM site, and it contains detailed information about how it works. Or, better still, read Chapter 166 of the Texas Health and Safety Code. It can be found at http://www.capitol.state.tx.us/statutes/docs/HS/content/htm/hs.002.00.000166.00.\ htm#166.001.00 Chapter 166 spells out ALL the possible advance directives and how they work. As Mike correctly says, protocol does not override state law. You are bound to follow state and federal law no matter what your protocols say. So read the law and inform yourself. I do not mean to criticize anyone with this comment. Finding the law is difficult sometimes even for lawyers. However, often folks who have questions about legal questions haven't tried to find the applicable regulations because they really do not know how to do it. So here's my recipe for research. Go to Google.com and put in some words that describe what you're looking for. In this case, I used " Texas Out of Hospital Do Not Resuscitate " and I was immediately taken to the BEM site and also the Health and Safety Code reference. It helps if you have a working knowledge of where law is found. In Texas, all the laws that govern EMS services are found in the Texas Health and Safety Code. Most of them are in Chapter 773. But even if you don't know that, Google will take you there. So before asking the list for advice, try to find the answer yourself through Google. It will save you a lot of time and result in your finding the REAL answers rather than the opinions of us list trolls. Not that we're either right or wrong. But when you can find the law and read it for yourself, you're better off. As Billie Holliday sang, " God Bless The Child That's Got His Own. " Bottom line for OOH DNRs: If somebody says " We want everything done, " do it. Of course, there are zillions of variable scenarios that may come into play at the scene of a full arrest, including coded patients that we know and have worked on multiple times and may have a mindset about what should be done that's skewed, forged DNRs, people pretending to be family members who have in fact just killed the patient with injections of lead or more subtle agents; family members who disagree about what should be done, and people who have no legal relationship to the patient but who are screaming DO SOMETHING and you don't have a clue who they are, what their legal status is, or why they're there. So when in doubt, work them. There have been no successful cases based upon wrongful resuscitation that I am aware of. People have sued for wrongful resuscitation, but to my knowledge there hasn't been a case where anybody was held liable for not following an OOH DNR when there were questionable circumstances. If anybody knows of such a case, please immediately let me know about it. Best, GG In a message dated 7/22/2004 7:40:49 PM Central Daylight Time, hatfield@... writes: I disagree. Protocol does not override state law, or personal choice (exception given to extenuating circumstances), 'because my protocol said so' is no defense. Albeit a rare occurrence, this situation, at best, will be one for a phone call to your Medical Director, or online medical control. When brought this up the first time, I don't think we got a clear answer to it, and like him, I am still curious. Mike From: Donnie Stone When in doubt, work the patient. I would rather be on trial for helping someone than neglecting to help someone. In my protocols it states (paraphrasing of course) if ONE family member says to do CPR, the DNR is revoked and CPR is to be continued even if there is a living will, advanced directive, or State of Texas DNR. The protocol is plain and simple, work the pt if the family objects to stopping CPR. D. Stone If a person signs a DNR while they are competent and able to make reasonable and informed decisions about their healthcare, can a family member or POA revoke or rescind that DNR later in the person's life when they are deemed to be incompetent or unable to decide for themselves? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 22, 2004 Report Share Posted July 22, 2004 Please folks, read the law. It is readily available for all to read and see for themselves what it says. The official DNR form is available on the TDH BEM site, and it contains detailed information about how it works. Or, better still, read Chapter 166 of the Texas Health and Safety Code. It can be found at http://www.capitol.state.tx.us/statutes/docs/HS/content/htm/hs.002.00.000166.00.\ htm#166.001.00 Chapter 166 spells out ALL the possible advance directives and how they work. As Mike correctly says, protocol does not override state law. You are bound to follow state and federal law no matter what your protocols say. So read the law and inform yourself. I do not mean to criticize anyone with this comment. Finding the law is difficult sometimes even for lawyers. However, often folks who have questions about legal questions haven't tried to find the applicable regulations because they really do not know how to do it. So here's my recipe for research. Go to Google.com and put in some words that describe what you're looking for. In this case, I used " Texas Out of Hospital Do Not Resuscitate " and I was immediately taken to the BEM site and also the Health and Safety Code reference. It helps if you have a working knowledge of where law is found. In Texas, all the laws that govern EMS services are found in the Texas Health and Safety Code. Most of them are in Chapter 773. But even if you don't know that, Google will take you there. So before asking the list for advice, try to find the answer yourself through Google. It will save you a lot of time and result in your finding the REAL answers rather than the opinions of us list trolls. Not that we're either right or wrong. But when you can find the law and read it for yourself, you're better off. As Billie Holliday sang, " God Bless The Child That's Got His Own. " Bottom line for OOH DNRs: If somebody says " We want everything done, " do it. Of course, there are zillions of variable scenarios that may come into play at the scene of a full arrest, including coded patients that we know and have worked on multiple times and may have a mindset about what should be done that's skewed, forged DNRs, people pretending to be family members who have in fact just killed the patient with injections of lead or more subtle agents; family members who disagree about what should be done, and people who have no legal relationship to the patient but who are screaming DO SOMETHING and you don't have a clue who they are, what their legal status is, or why they're there. So when in doubt, work them. There have been no successful cases based upon wrongful resuscitation that I am aware of. People have sued for wrongful resuscitation, but to my knowledge there hasn't been a case where anybody was held liable for not following an OOH DNR when there were questionable circumstances. If anybody knows of such a case, please immediately let me know about it. Best, GG In a message dated 7/22/2004 7:40:49 PM Central Daylight Time, hatfield@... writes: I disagree. Protocol does not override state law, or personal choice (exception given to extenuating circumstances), 'because my protocol said so' is no defense. Albeit a rare occurrence, this situation, at best, will be one for a phone call to your Medical Director, or online medical control. When brought this up the first time, I don't think we got a clear answer to it, and like him, I am still curious. Mike From: Donnie Stone When in doubt, work the patient. I would rather be on trial for helping someone than neglecting to help someone. In my protocols it states (paraphrasing of course) if ONE family member says to do CPR, the DNR is revoked and CPR is to be continued even if there is a living will, advanced directive, or State of Texas DNR. The protocol is plain and simple, work the pt if the family objects to stopping CPR. D. Stone If a person signs a DNR while they are competent and able to make reasonable and informed decisions about their healthcare, can a family member or POA revoke or rescind that DNR later in the person's life when they are deemed to be incompetent or unable to decide for themselves? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 22, 2004 Report Share Posted July 22, 2004 I disagree. Protocol does not override state law, or personal choice (exception given to extenuating circumstances), 'because my protocol said so' is no defense. Albeit a rare occurrence, this situation, at best, will be one for a phone call to your Medical Director, or online medical control. When brought this up the first time, I don't think we got a clear answer to it, and like him, I am still curious. Mike From: Donnie Stone When in doubt, work the patient. I would rather be on trial for helping someone than neglecting to help someone. In my protocols it states (paraphrasing of course) if ONE family member says to do CPR, the DNR is revoked and CPR is to be continued even if there is a living will, advanced directive, or State of Texas DNR. The protocol is plain and simple, work the pt if the family objects to stopping CPR. D. Stone If a person signs a DNR while they are competent and able to make reasonable and informed decisions about their healthcare, can a family member or POA revoke or rescind that DNR later in the person's life when they are deemed to be incompetent or unable to decide for themselves? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 22, 2004 Report Share Posted July 22, 2004 I disagree. Protocol does not override state law, or personal choice (exception given to extenuating circumstances), 'because my protocol said so' is no defense. Albeit a rare occurrence, this situation, at best, will be one for a phone call to your Medical Director, or online medical control. When brought this up the first time, I don't think we got a clear answer to it, and like him, I am still curious. Mike From: Donnie Stone When in doubt, work the patient. I would rather be on trial for helping someone than neglecting to help someone. In my protocols it states (paraphrasing of course) if ONE family member says to do CPR, the DNR is revoked and CPR is to be continued even if there is a living will, advanced directive, or State of Texas DNR. The protocol is plain and simple, work the pt if the family objects to stopping CPR. D. Stone If a person signs a DNR while they are competent and able to make reasonable and informed decisions about their healthcare, can a family member or POA revoke or rescind that DNR later in the person's life when they are deemed to be incompetent or unable to decide for themselves? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 23, 2004 Report Share Posted July 23, 2004 Gene, Does this mean that if granny has a cardiac arrest with a DNR on hand, that her son can revoke it because she is no longer possess " present legal capacity " and is not legally mentally competent? Ralph , LP wegandy1938@... wrote: I'll try to guide y'all through an analysis of this. Scroll down. Gene G. In a message dated 7/22/2004 2:50:31 PM Central Daylight Time, supervisor@... writes: I've sent this out before, but received very little input other than a few opinions. Does anyone have any factual info? If a person signs a DNR while they are competent and able to make reasonable and informed decisions about their healthcare, can a family member or POA revoke or rescind that DNR later in the person's life when they are deemed to be incompetent or unable to decide for themselves? Go to this site and look at the form, and it will explain the procedures clearly. http://www.tdh.state.tx.us/hcqs/ems/dnr.pdf The patient may execute the DNR at a time when he is mentally competent (an incorrect term--the patient must possess " present legal capacity " as well as being legally mentally competent. Loose language has been an ongoing problem with these issues). If the patient is lacks the capacity to execute the DNR, it may be executed by anyone who has the legal right to make such a determination under the law, which is found in the Texas Family Code for Texas patients. If there are no patient surrogates available or they do not want to act, two physicians may execute the document. The DNR may be revoked by ANY of the persons qualified to execute it. Therefore, it a patient has executed a DNR at a time when he had present mental capacity and legal competence, but later becomes incompetent, any of the surrogates may revoke it. This is spelled out in detail on the back of the official DNR form. Best, GG Bullard BS, LP Training Coordinator Lubbock Aid Ambulance Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 23, 2004 Report Share Posted July 23, 2004 Gene, Does this mean that if granny has a cardiac arrest with a DNR on hand, that her son can revoke it because she is no longer possess " present legal capacity " and is not legally mentally competent? Ralph , LP wegandy1938@... wrote: I'll try to guide y'all through an analysis of this. Scroll down. Gene G. In a message dated 7/22/2004 2:50:31 PM Central Daylight Time, supervisor@... writes: I've sent this out before, but received very little input other than a few opinions. Does anyone have any factual info? If a person signs a DNR while they are competent and able to make reasonable and informed decisions about their healthcare, can a family member or POA revoke or rescind that DNR later in the person's life when they are deemed to be incompetent or unable to decide for themselves? Go to this site and look at the form, and it will explain the procedures clearly. http://www.tdh.state.tx.us/hcqs/ems/dnr.pdf The patient may execute the DNR at a time when he is mentally competent (an incorrect term--the patient must possess " present legal capacity " as well as being legally mentally competent. Loose language has been an ongoing problem with these issues). If the patient is lacks the capacity to execute the DNR, it may be executed by anyone who has the legal right to make such a determination under the law, which is found in the Texas Family Code for Texas patients. If there are no patient surrogates available or they do not want to act, two physicians may execute the document. The DNR may be revoked by ANY of the persons qualified to execute it. Therefore, it a patient has executed a DNR at a time when he had present mental capacity and legal competence, but later becomes incompetent, any of the surrogates may revoke it. This is spelled out in detail on the back of the official DNR form. Best, GG Bullard BS, LP Training Coordinator Lubbock Aid Ambulance Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 23, 2004 Report Share Posted July 23, 2004 Gene, Does this mean that if granny has a cardiac arrest with a DNR on hand, that her son can revoke it because she is no longer possess " present legal capacity " and is not legally mentally competent? Ralph , LP wegandy1938@... wrote: I'll try to guide y'all through an analysis of this. Scroll down. Gene G. In a message dated 7/22/2004 2:50:31 PM Central Daylight Time, supervisor@... writes: I've sent this out before, but received very little input other than a few opinions. Does anyone have any factual info? If a person signs a DNR while they are competent and able to make reasonable and informed decisions about their healthcare, can a family member or POA revoke or rescind that DNR later in the person's life when they are deemed to be incompetent or unable to decide for themselves? Go to this site and look at the form, and it will explain the procedures clearly. http://www.tdh.state.tx.us/hcqs/ems/dnr.pdf The patient may execute the DNR at a time when he is mentally competent (an incorrect term--the patient must possess " present legal capacity " as well as being legally mentally competent. Loose language has been an ongoing problem with these issues). If the patient is lacks the capacity to execute the DNR, it may be executed by anyone who has the legal right to make such a determination under the law, which is found in the Texas Family Code for Texas patients. If there are no patient surrogates available or they do not want to act, two physicians may execute the document. The DNR may be revoked by ANY of the persons qualified to execute it. Therefore, it a patient has executed a DNR at a time when he had present mental capacity and legal competence, but later becomes incompetent, any of the surrogates may revoke it. This is spelled out in detail on the back of the official DNR form. Best, GG Bullard BS, LP Training Coordinator Lubbock Aid Ambulance Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 23, 2004 Report Share Posted July 23, 2004 Yes it does...A family member may revoke the DNR at any time.... Ralph wrote:Gene, Does this mean that if granny has a cardiac arrest with a DNR on hand, that her son can revoke it because she is no longer possess " present legal capacity " and is not legally mentally competent? Ralph , LP Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 23, 2004 Report Share Posted July 23, 2004 Yes it does...A family member may revoke the DNR at any time.... Ralph wrote:Gene, Does this mean that if granny has a cardiac arrest with a DNR on hand, that her son can revoke it because she is no longer possess " present legal capacity " and is not legally mentally competent? Ralph , LP Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 23, 2004 Report Share Posted July 23, 2004 Yes it does...A family member may revoke the DNR at any time.... Ralph wrote:Gene, Does this mean that if granny has a cardiac arrest with a DNR on hand, that her son can revoke it because she is no longer possess " present legal capacity " and is not legally mentally competent? Ralph , LP Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 23, 2004 Report Share Posted July 23, 2004 Thank you. I'm curious to know why you skipped out on this one last time. Remember this: I cannot answer the DNR question because I lack alligator shoes. I lack ALL shoes except for an old pair of New Balance runners. I do have a couple of pairs of ostrich boots, some elephants, and lots of sharkskins and calf and maybe a kangaroo pair or two. But alligator shoes, no. Sorry. GG Bullard BS, LP Training Coordinator Lubbock Aid Ambulance _____ From: wegandy1938@... Sent: Thursday, July 22, 2004 10:02 PM To: Subject: Re: DNR Again I'll try to guide y'all through an analysis of this. Scroll down. Gene G. In a message dated 7/22/2004 2:50:31 PM Central Daylight Time, supervisor@... writes: I've sent this out before, but received very little input other than a few opinions. Does anyone have any factual info? If a person signs a DNR while they are competent and able to make reasonable and informed decisions about their healthcare, can a family member or POA revoke or rescind that DNR later in the person's life when they are deemed to be incompetent or unable to decide for themselves? Go to this site and look at the form, and it will explain the procedures clearly. http://www.tdh.state.tx.us/hcqs/ems/dnr.pdf The patient may execute the DNR at a time when he is mentally competent (an incorrect term--the patient must possess " present legal capacity " as well as being legally mentally competent. Loose language has been an ongoing problem with these issues). If the patient is lacks the capacity to execute the DNR, it may be executed by anyone who has the legal right to make such a determination under the law, which is found in the Texas Family Code for Texas patients. If there are no patient surrogates available or they do not want to act, two physicians may execute the document. The DNR may be revoked by ANY of the persons qualified to execute it. Therefore, it a patient has executed a DNR at a time when he had present mental capacity and legal competence, but later becomes incompetent, any of the surrogates may revoke it. This is spelled out in detail on the back of the official DNR form. Best, GG Bullard BS, LP Training Coordinator Lubbock Aid Ambulance Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 23, 2004 Report Share Posted July 23, 2004 Thank you. I'm curious to know why you skipped out on this one last time. Remember this: I cannot answer the DNR question because I lack alligator shoes. I lack ALL shoes except for an old pair of New Balance runners. I do have a couple of pairs of ostrich boots, some elephants, and lots of sharkskins and calf and maybe a kangaroo pair or two. But alligator shoes, no. Sorry. GG Bullard BS, LP Training Coordinator Lubbock Aid Ambulance _____ From: wegandy1938@... Sent: Thursday, July 22, 2004 10:02 PM To: Subject: Re: DNR Again I'll try to guide y'all through an analysis of this. Scroll down. Gene G. In a message dated 7/22/2004 2:50:31 PM Central Daylight Time, supervisor@... writes: I've sent this out before, but received very little input other than a few opinions. Does anyone have any factual info? If a person signs a DNR while they are competent and able to make reasonable and informed decisions about their healthcare, can a family member or POA revoke or rescind that DNR later in the person's life when they are deemed to be incompetent or unable to decide for themselves? Go to this site and look at the form, and it will explain the procedures clearly. http://www.tdh.state.tx.us/hcqs/ems/dnr.pdf The patient may execute the DNR at a time when he is mentally competent (an incorrect term--the patient must possess " present legal capacity " as well as being legally mentally competent. Loose language has been an ongoing problem with these issues). If the patient is lacks the capacity to execute the DNR, it may be executed by anyone who has the legal right to make such a determination under the law, which is found in the Texas Family Code for Texas patients. If there are no patient surrogates available or they do not want to act, two physicians may execute the document. The DNR may be revoked by ANY of the persons qualified to execute it. Therefore, it a patient has executed a DNR at a time when he had present mental capacity and legal competence, but later becomes incompetent, any of the surrogates may revoke it. This is spelled out in detail on the back of the official DNR form. Best, GG Bullard BS, LP Training Coordinator Lubbock Aid Ambulance Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 23, 2004 Report Share Posted July 23, 2004 Thank you. I'm curious to know why you skipped out on this one last time. Remember this: I cannot answer the DNR question because I lack alligator shoes. I lack ALL shoes except for an old pair of New Balance runners. I do have a couple of pairs of ostrich boots, some elephants, and lots of sharkskins and calf and maybe a kangaroo pair or two. But alligator shoes, no. Sorry. GG Bullard BS, LP Training Coordinator Lubbock Aid Ambulance _____ From: wegandy1938@... Sent: Thursday, July 22, 2004 10:02 PM To: Subject: Re: DNR Again I'll try to guide y'all through an analysis of this. Scroll down. Gene G. In a message dated 7/22/2004 2:50:31 PM Central Daylight Time, supervisor@... writes: I've sent this out before, but received very little input other than a few opinions. Does anyone have any factual info? If a person signs a DNR while they are competent and able to make reasonable and informed decisions about their healthcare, can a family member or POA revoke or rescind that DNR later in the person's life when they are deemed to be incompetent or unable to decide for themselves? Go to this site and look at the form, and it will explain the procedures clearly. http://www.tdh.state.tx.us/hcqs/ems/dnr.pdf The patient may execute the DNR at a time when he is mentally competent (an incorrect term--the patient must possess " present legal capacity " as well as being legally mentally competent. Loose language has been an ongoing problem with these issues). If the patient is lacks the capacity to execute the DNR, it may be executed by anyone who has the legal right to make such a determination under the law, which is found in the Texas Family Code for Texas patients. If there are no patient surrogates available or they do not want to act, two physicians may execute the document. The DNR may be revoked by ANY of the persons qualified to execute it. Therefore, it a patient has executed a DNR at a time when he had present mental capacity and legal competence, but later becomes incompetent, any of the surrogates may revoke it. This is spelled out in detail on the back of the official DNR form. Best, GG Bullard BS, LP Training Coordinator Lubbock Aid Ambulance Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 23, 2004 Report Share Posted July 23, 2004 Ralph, Great question. I interpret the law to say " yes. " There have been no court decisions on that subject, so any answer that I give is presumptive, but on the theory of always working the code when in doubt, I would say work it to be safe. Now, I'll twist your mind a little bit. Let's say that there are a son and a daughter present who are both adults and one of them wants her worked and the other one does not. What then? GG In a message dated 7/23/2004 8:06:28 AM Central Daylight Time, rbr@... writes: Gene, Does this mean that if granny has a cardiac arrest with a DNR on hand, that her son can revoke it because she is no longer possess " present legal capacity " and is not legally mentally competent? Ralph , LP wegandy1938@... wrote: I'll try to guide y'all through an analysis of this. Scroll down. Gene G. In a message dated 7/22/2004 2:50:31 PM Central Daylight Time, supervisor@... writes: I've sent this out before, but received very little input other than a few opinions. Does anyone have any factual info? If a person signs a DNR while they are competent and able to make reasonable and informed decisions about their healthcare, can a family member or POA revoke or rescind that DNR later in the person's life when they are deemed to be incompetent or unable to decide for themselves? Go to this site and look at the form, and it will explain the procedures clearly. http://www.tdh.state.tx.us/hcqs/ems/dnr.pdf The patient may execute the DNR at a time when he is mentally competent (an incorrect term--the patient must possess " present legal capacity " as well as being legally mentally competent. Loose language has been an ongoing problem with these issues). If the patient is lacks the capacity to execute the DNR, it may be executed by anyone who has the legal right to make such a determination under the law, which is found in the Texas Family Code for Texas patients. If there are no patient surrogates available or they do not want to act, two physicians may execute the document. The DNR may be revoked by ANY of the persons qualified to execute it. Therefore, it a patient has executed a DNR at a time when he had present mental capacity and legal competence, but later becomes incompetent, any of the surrogates may revoke it. This is spelled out in detail on the back of the official DNR form. Best, GG Bullard BS, LP Training Coordinator Lubbock Aid Ambulance [Non-text portions of this message have been removed] Yahoo! Groups Links [Non-text portions of this message have been removed] Yahoo! Groups Links [Non-text portions of this message have been removed] Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 23, 2004 Report Share Posted July 23, 2004 Ralph, Great question. I interpret the law to say " yes. " There have been no court decisions on that subject, so any answer that I give is presumptive, but on the theory of always working the code when in doubt, I would say work it to be safe. Now, I'll twist your mind a little bit. Let's say that there are a son and a daughter present who are both adults and one of them wants her worked and the other one does not. What then? GG In a message dated 7/23/2004 8:06:28 AM Central Daylight Time, rbr@... writes: Gene, Does this mean that if granny has a cardiac arrest with a DNR on hand, that her son can revoke it because she is no longer possess " present legal capacity " and is not legally mentally competent? Ralph , LP wegandy1938@... wrote: I'll try to guide y'all through an analysis of this. Scroll down. Gene G. In a message dated 7/22/2004 2:50:31 PM Central Daylight Time, supervisor@... writes: I've sent this out before, but received very little input other than a few opinions. Does anyone have any factual info? If a person signs a DNR while they are competent and able to make reasonable and informed decisions about their healthcare, can a family member or POA revoke or rescind that DNR later in the person's life when they are deemed to be incompetent or unable to decide for themselves? Go to this site and look at the form, and it will explain the procedures clearly. http://www.tdh.state.tx.us/hcqs/ems/dnr.pdf The patient may execute the DNR at a time when he is mentally competent (an incorrect term--the patient must possess " present legal capacity " as well as being legally mentally competent. Loose language has been an ongoing problem with these issues). If the patient is lacks the capacity to execute the DNR, it may be executed by anyone who has the legal right to make such a determination under the law, which is found in the Texas Family Code for Texas patients. If there are no patient surrogates available or they do not want to act, two physicians may execute the document. The DNR may be revoked by ANY of the persons qualified to execute it. Therefore, it a patient has executed a DNR at a time when he had present mental capacity and legal competence, but later becomes incompetent, any of the surrogates may revoke it. This is spelled out in detail on the back of the official DNR form. Best, GG Bullard BS, LP Training Coordinator Lubbock Aid Ambulance [Non-text portions of this message have been removed] Yahoo! Groups Links [Non-text portions of this message have been removed] Yahoo! Groups Links [Non-text portions of this message have been removed] Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 23, 2004 Report Share Posted July 23, 2004 Ralph, Great question. I interpret the law to say " yes. " There have been no court decisions on that subject, so any answer that I give is presumptive, but on the theory of always working the code when in doubt, I would say work it to be safe. Now, I'll twist your mind a little bit. Let's say that there are a son and a daughter present who are both adults and one of them wants her worked and the other one does not. What then? GG In a message dated 7/23/2004 8:06:28 AM Central Daylight Time, rbr@... writes: Gene, Does this mean that if granny has a cardiac arrest with a DNR on hand, that her son can revoke it because she is no longer possess " present legal capacity " and is not legally mentally competent? Ralph , LP wegandy1938@... wrote: I'll try to guide y'all through an analysis of this. Scroll down. Gene G. In a message dated 7/22/2004 2:50:31 PM Central Daylight Time, supervisor@... writes: I've sent this out before, but received very little input other than a few opinions. Does anyone have any factual info? If a person signs a DNR while they are competent and able to make reasonable and informed decisions about their healthcare, can a family member or POA revoke or rescind that DNR later in the person's life when they are deemed to be incompetent or unable to decide for themselves? Go to this site and look at the form, and it will explain the procedures clearly. http://www.tdh.state.tx.us/hcqs/ems/dnr.pdf The patient may execute the DNR at a time when he is mentally competent (an incorrect term--the patient must possess " present legal capacity " as well as being legally mentally competent. Loose language has been an ongoing problem with these issues). If the patient is lacks the capacity to execute the DNR, it may be executed by anyone who has the legal right to make such a determination under the law, which is found in the Texas Family Code for Texas patients. If there are no patient surrogates available or they do not want to act, two physicians may execute the document. The DNR may be revoked by ANY of the persons qualified to execute it. Therefore, it a patient has executed a DNR at a time when he had present mental capacity and legal competence, but later becomes incompetent, any of the surrogates may revoke it. This is spelled out in detail on the back of the official DNR form. Best, GG Bullard BS, LP Training Coordinator Lubbock Aid Ambulance [Non-text portions of this message have been removed] Yahoo! Groups Links [Non-text portions of this message have been removed] Yahoo! Groups Links [Non-text portions of this message have been removed] Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 23, 2004 Report Share Posted July 23, 2004 Gene, I followed your advice and went to the Health and Safety Code. This actually brought up more questions. The DNR may be revoked by ANY of the persons qualified to execute it. Therefore, it a patient has executed a DNR at a time when he had present mental capacity and legal competence, but later becomes incompetent, any of the surrogates may revoke it. This is spelled out in detail on the back of the official DNR form. Persons are qualified to execute a DNR when their decision is " based on knowledge of what the patient would desire, if known. " Therefore, if a preexisting knowledge of the person's wishes is required to be considered a " qualified relative " , that would mean the decisions would have to be in line with what the patient desires. If the decisions are not in line with a patient's wishes, is that person still considered a " qualified relative " ? (Section166.039a-c) I also find that if a person fits the scenario I proposed, designated persons and physicians " shall comply with the out-of-hospital DNR order. " (Section 166.087) I'm no attorney. What do you think? Bullard BS, LP Training Coordinator Lubbock Aid Ambulance (By the way, I won't reference you, your advice, nor your participation in this discussion should I encounter any future litigation regarding this matter.) _____ From: wegandy1938@... Sent: Thursday, July 22, 2004 10:02 PM To: Subject: Re: DNR Again I'll try to guide y'all through an analysis of this. Scroll down. Gene G. In a message dated 7/22/2004 2:50:31 PM Central Daylight Time, supervisor@... writes: I've sent this out before, but received very little input other than a few opinions. Does anyone have any factual info? If a person signs a DNR while they are competent and able to make reasonable and informed decisions about their healthcare, can a family member or POA revoke or rescind that DNR later in the person's life when they are deemed to be incompetent or unable to decide for themselves? Go to this site and look at the form, and it will explain the procedures clearly. http://www.tdh.state.tx.us/hcqs/ems/dnr.pdf The patient may execute the DNR at a time when he is mentally competent (an incorrect term--the patient must possess " present legal capacity " as well as being legally mentally competent. Loose language has been an ongoing problem with these issues). If the patient is lacks the capacity to execute the DNR, it may be executed by anyone who has the legal right to make such a determination under the law, which is found in the Texas Family Code for Texas patients. If there are no patient surrogates available or they do not want to act, two physicians may execute the document. The DNR may be revoked by ANY of the persons qualified to execute it. Therefore, it a patient has executed a DNR at a time when he had present mental capacity and legal competence, but later becomes incompetent, any of the surrogates may revoke it. This is spelled out in detail on the back of the official DNR form. Best, GG Bullard BS, LP Training Coordinator Lubbock Aid Ambulance Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 23, 2004 Report Share Posted July 23, 2004 Just wasn't in the mood. Working on something else. Deadline, et cetera. GG In a message dated 7/23/2004 1:56:28 PM Central Daylight Time, supervisor@... writes: Thank you. I'm curious to know why you skipped out on this one last time. Remember this: I cannot answer the DNR question because I lack alligator shoes. I lack ALL shoes except for an old pair of New Balance runners. I do have a couple of pairs of ostrich boots, some elephants, and lots of sharkskins and calf and maybe a kangaroo pair or two. But alligator shoes, no. Sorry. GG Bullard BS, LP Training Coordinator Lubbock Aid Ambulance _____ From: wegandy1938@... Sent: Thursday, July 22, 2004 10:02 PM To: Subject: Re: DNR Again I'll try to guide y'all through an analysis of this. Scroll down. Gene G. In a message dated 7/22/2004 2:50:31 PM Central Daylight Time, supervisor@... writes: I've sent this out before, but received very little input other than a few opinions. Does anyone have any factual info? If a person signs a DNR while they are competent and able to make reasonable and informed decisions about their healthcare, can a family member or POA revoke or rescind that DNR later in the person's life when they are deemed to be incompetent or unable to decide for themselves? Go to this site and look at the form, and it will explain the procedures clearly. http://www.tdh.state.tx.us/hcqs/ems/dnr.pdf The patient may execute the DNR at a time when he is mentally competent (an incorrect term--the patient must possess " present legal capacity " as well as being legally mentally competent. Loose language has been an ongoing problem with these issues). If the patient is lacks the capacity to execute the DNR, it may be executed by anyone who has the legal right to make such a determination under the law, which is found in the Texas Family Code for Texas patients. If there are no patient surrogates available or they do not want to act, two physicians may execute the document. The DNR may be revoked by ANY of the persons qualified to execute it. Therefore, it a patient has executed a DNR at a time when he had present mental capacity and legal competence, but later becomes incompetent, any of the surrogates may revoke it. This is spelled out in detail on the back of the official DNR form. Best, GG Bullard BS, LP Training Coordinator Lubbock Aid Ambulance [Non-text portions of this message have been removed] Yahoo! Groups Links [Non-text portions of this message have been removed] Yahoo! Groups Sponsor ADVERTISEMENT <http://us.ard.yahoo.com/SIG=12c6ksmqd/M=295196.4901138.6071305.3001176/D=gr phealth/S=1705061161:HM/EXP=1090638144/A=2128215/R=0/SIG=10se96mf6/*http:/co mpanion.yahoo.com> click here <http://us.adserver.yahoo.com/l?M=295196.4901138.6071305.3001176/D=grphealth /S=:HM/A=2128215/rand=107619492> _____ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 23, 2004 Report Share Posted July 23, 2004 Just wasn't in the mood. Working on something else. Deadline, et cetera. GG In a message dated 7/23/2004 1:56:28 PM Central Daylight Time, supervisor@... writes: Thank you. I'm curious to know why you skipped out on this one last time. Remember this: I cannot answer the DNR question because I lack alligator shoes. I lack ALL shoes except for an old pair of New Balance runners. I do have a couple of pairs of ostrich boots, some elephants, and lots of sharkskins and calf and maybe a kangaroo pair or two. But alligator shoes, no. Sorry. GG Bullard BS, LP Training Coordinator Lubbock Aid Ambulance _____ From: wegandy1938@... Sent: Thursday, July 22, 2004 10:02 PM To: Subject: Re: DNR Again I'll try to guide y'all through an analysis of this. Scroll down. Gene G. In a message dated 7/22/2004 2:50:31 PM Central Daylight Time, supervisor@... writes: I've sent this out before, but received very little input other than a few opinions. Does anyone have any factual info? If a person signs a DNR while they are competent and able to make reasonable and informed decisions about their healthcare, can a family member or POA revoke or rescind that DNR later in the person's life when they are deemed to be incompetent or unable to decide for themselves? Go to this site and look at the form, and it will explain the procedures clearly. http://www.tdh.state.tx.us/hcqs/ems/dnr.pdf The patient may execute the DNR at a time when he is mentally competent (an incorrect term--the patient must possess " present legal capacity " as well as being legally mentally competent. Loose language has been an ongoing problem with these issues). If the patient is lacks the capacity to execute the DNR, it may be executed by anyone who has the legal right to make such a determination under the law, which is found in the Texas Family Code for Texas patients. If there are no patient surrogates available or they do not want to act, two physicians may execute the document. The DNR may be revoked by ANY of the persons qualified to execute it. Therefore, it a patient has executed a DNR at a time when he had present mental capacity and legal competence, but later becomes incompetent, any of the surrogates may revoke it. This is spelled out in detail on the back of the official DNR form. Best, GG Bullard BS, LP Training Coordinator Lubbock Aid Ambulance [Non-text portions of this message have been removed] Yahoo! Groups Links [Non-text portions of this message have been removed] Yahoo! Groups Sponsor ADVERTISEMENT <http://us.ard.yahoo.com/SIG=12c6ksmqd/M=295196.4901138.6071305.3001176/D=gr phealth/S=1705061161:HM/EXP=1090638144/A=2128215/R=0/SIG=10se96mf6/*http:/co mpanion.yahoo.com> click here <http://us.adserver.yahoo.com/l?M=295196.4901138.6071305.3001176/D=grphealth /S=:HM/A=2128215/rand=107619492> _____ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 23, 2004 Report Share Posted July 23, 2004 your so mean Gene! LOL! Lee Re: DNR Again Ralph, Great question. I interpret the law to say " yes. " There have been no court decisions on that subject, so any answer that I give is presumptive, but on the theory of always working the code when in doubt, I would say work it to be safe. Now, I'll twist your mind a little bit. Let's say that there are a son and a daughter present who are both adults and one of them wants her worked and the other one does not. What then? GG In a message dated 7/23/2004 8:06:28 AM Central Daylight Time, rbr@... writes: Gene, Does this mean that if granny has a cardiac arrest with a DNR on hand, that her son can revoke it because she is no longer possess " present legal capacity " and is not legally mentally competent? Ralph , LP wegandy1938@... wrote: I'll try to guide y'all through an analysis of this. Scroll down. Gene G. In a message dated 7/22/2004 2:50:31 PM Central Daylight Time, supervisor@... writes: I've sent this out before, but received very little input other than a few opinions. Does anyone have any factual info? If a person signs a DNR while they are competent and able to make reasonable and informed decisions about their healthcare, can a family member or POA revoke or rescind that DNR later in the person's life when they are deemed to be incompetent or unable to decide for themselves? Go to this site and look at the form, and it will explain the procedures clearly. http://www.tdh.state.tx.us/hcqs/ems/dnr.pdf The patient may execute the DNR at a time when he is mentally competent (an incorrect term--the patient must possess " present legal capacity " as well as being legally mentally competent. Loose language has been an ongoing problem with these issues). If the patient is lacks the capacity to execute the DNR, it may be executed by anyone who has the legal right to make such a determination under the law, which is found in the Texas Family Code for Texas patients. If there are no patient surrogates available or they do not want to act, two physicians may execute the document. The DNR may be revoked by ANY of the persons qualified to execute it. Therefore, it a patient has executed a DNR at a time when he had present mental capacity and legal competence, but later becomes incompetent, any of the surrogates may revoke it. This is spelled out in detail on the back of the official DNR form. Best, GG Bullard BS, LP Training Coordinator Lubbock Aid Ambulance [Non-text portions of this message have been removed] Yahoo! Groups Links [Non-text portions of this message have been removed] Yahoo! Groups Links [Non-text portions of this message have been removed] Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 23, 2004 Report Share Posted July 23, 2004 your so mean Gene! LOL! Lee Re: DNR Again Ralph, Great question. I interpret the law to say " yes. " There have been no court decisions on that subject, so any answer that I give is presumptive, but on the theory of always working the code when in doubt, I would say work it to be safe. Now, I'll twist your mind a little bit. Let's say that there are a son and a daughter present who are both adults and one of them wants her worked and the other one does not. What then? GG In a message dated 7/23/2004 8:06:28 AM Central Daylight Time, rbr@... writes: Gene, Does this mean that if granny has a cardiac arrest with a DNR on hand, that her son can revoke it because she is no longer possess " present legal capacity " and is not legally mentally competent? Ralph , LP wegandy1938@... wrote: I'll try to guide y'all through an analysis of this. Scroll down. Gene G. In a message dated 7/22/2004 2:50:31 PM Central Daylight Time, supervisor@... writes: I've sent this out before, but received very little input other than a few opinions. Does anyone have any factual info? If a person signs a DNR while they are competent and able to make reasonable and informed decisions about their healthcare, can a family member or POA revoke or rescind that DNR later in the person's life when they are deemed to be incompetent or unable to decide for themselves? Go to this site and look at the form, and it will explain the procedures clearly. http://www.tdh.state.tx.us/hcqs/ems/dnr.pdf The patient may execute the DNR at a time when he is mentally competent (an incorrect term--the patient must possess " present legal capacity " as well as being legally mentally competent. Loose language has been an ongoing problem with these issues). If the patient is lacks the capacity to execute the DNR, it may be executed by anyone who has the legal right to make such a determination under the law, which is found in the Texas Family Code for Texas patients. If there are no patient surrogates available or they do not want to act, two physicians may execute the document. The DNR may be revoked by ANY of the persons qualified to execute it. Therefore, it a patient has executed a DNR at a time when he had present mental capacity and legal competence, but later becomes incompetent, any of the surrogates may revoke it. This is spelled out in detail on the back of the official DNR form. Best, GG Bullard BS, LP Training Coordinator Lubbock Aid Ambulance [Non-text portions of this message have been removed] Yahoo! Groups Links [Non-text portions of this message have been removed] Yahoo! Groups Links [Non-text portions of this message have been removed] Quote Link to comment Share on other sites More sharing options...
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