Re: DNR Again

[Guest guest]

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]

[Guest guest]

From: wegandy1938@...

>>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

Take a vote and let the majority rule, in this case, it would be one sibling

and the mother against the other sibling. No need to worry about the mother

being dead, she's a democrat, and we all know they vote years after they

die.....

Mike

[Guest guest]

From: wegandy1938@...

>>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

Take a vote and let the majority rule, in this case, it would be one sibling

and the mother against the other sibling. No need to worry about the mother

being dead, she's a democrat, and we all know they vote years after they

die.....

Mike

[Guest guest]

From: wegandy1938@...

>>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

Take a vote and let the majority rule, in this case, it would be one sibling

and the mother against the other sibling. No need to worry about the mother

being dead, she's a democrat, and we all know they vote years after they

die.....

Mike

[Guest guest]

If one family member objects to stopping CPR....then you continue with your

efforts. Remember, cover your butt. Now a days you aren't treating the

patient, you are treating the lawyers....

D. Stone

wegandy1938@... wrote:

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

[Guest guest]

If one family member objects to stopping CPR....then you continue with your

efforts. Remember, cover your butt. Now a days you aren't treating the

patient, you are treating the lawyers....

D. Stone

wegandy1938@... wrote:

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

[Guest guest]

If one family member objects to stopping CPR....then you continue with your

efforts. Remember, cover your butt. Now a days you aren't treating the

patient, you are treating the lawyers....

D. Stone

wegandy1938@... wrote:

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

[Guest guest]

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?

Well, While your crew (Hopefully more than 2) starts working the code, One

person explains to the family (Both) the decision to start and then contact

medical control. All it takes is just one to get it started. Unless the one

saying no has paper work that says they are the sole decision maker.

Just my little old humble opinion.

Tom LeNeveu

Learning Paramedic

[Guest guest]

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?

Well, While your crew (Hopefully more than 2) starts working the code, One

person explains to the family (Both) the decision to start and then contact

medical control. All it takes is just one to get it started. Unless the one

saying no has paper work that says they are the sole decision maker.

Just my little old humble opinion.

Tom LeNeveu

Learning Paramedic

[Guest guest]

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?

Well, While your crew (Hopefully more than 2) starts working the code, One

person explains to the family (Both) the decision to start and then contact

medical control. All it takes is just one to get it started. Unless the one

saying no has paper work that says they are the sole decision maker.

Just my little old humble opinion.

Tom LeNeveu

Learning Paramedic

[Guest guest]

That's because Democrats have brains.

GG

In a message dated 7/24/2004 1:36:00 AM Central Daylight Time,

hatfield@... writes:

From: wegandy1938@...

>>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

Take a vote and let the majority rule, in this case, it would be one sibling

and the mother against the other sibling. No need to worry about the mother

being dead, she's a democrat, and we all know they vote years after they

die.....

Mike

[Guest guest]

That's because Democrats have brains.

GG

In a message dated 7/24/2004 1:36:00 AM Central Daylight Time,

hatfield@... writes:

From: wegandy1938@...

>>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

Take a vote and let the majority rule, in this case, it would be one sibling

and the mother against the other sibling. No need to worry about the mother

being dead, she's a democrat, and we all know they vote years after they

die.....

Mike

[Guest guest]

That's because Democrats have brains.

GG

In a message dated 7/24/2004 1:36:00 AM Central Daylight Time,

hatfield@... writes:

From: wegandy1938@...

>>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

Take a vote and let the majority rule, in this case, it would be one sibling

and the mother against the other sibling. No need to worry about the mother

being dead, she's a democrat, and we all know they vote years after they

die.....

Mike

[Guest guest]

Theoretically correct. Practical problem: Unless you know the people

personally, you have to make sure that they are who they say they are. A

durable

power of attorney for health care must be executed in a certain way. There must

be two witnesses to the execution of the document, one of which may not be:

the person designated by the principal to make a health care decision on the

principal's behalf;

related to the principal by blood or marriage;

the principal's attending physician or an employee of the attending

physician;

entitled to a part of the principal's estate;

a person having a claim against the principal's estate;

an employee of a health care facility in which the principal is a patient if

the employee is providing direct care to the principal; or

an officer, director, partner, or business office employee of the health care

facility or of any parent organization of the health care facility.

You wouldn't know whether or not the document was valid unless you knew all

the parties and their circumstances.

The witnesses are not generally on scene. It is normal to get strangers to

act as the witnesses. So you wouldn't have any way to verify the validity of

the instrument.

What presumptions should you or could you make? Either that the document IS

valid or that it is not. The safest thing to do is to continue resuscitation

to the hospital and allow them to sort it out.

The scene of a code is neither the time nor place to check out a document's

validity.

GG

In a message dated 7/24/2004 9:34:58 AM Central Daylight Time,

FireMedic1633@... writes:

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?

Well, While your crew (Hopefully more than 2) starts working the code, One

person explains to the family (Both) the decision to start and then contact

medical control. All it takes is just one to get it started. Unless the one

saying no has paper work that says they are the sole decision maker.

Just my little old humble opinion.

Tom LeNeveu

Learning Paramedic

[Guest guest]

Theoretically correct. Practical problem: Unless you know the people

personally, you have to make sure that they are who they say they are. A

durable

power of attorney for health care must be executed in a certain way. There must

be two witnesses to the execution of the document, one of which may not be:

the person designated by the principal to make a health care decision on the

principal's behalf;

related to the principal by blood or marriage;

the principal's attending physician or an employee of the attending

physician;

entitled to a part of the principal's estate;

a person having a claim against the principal's estate;

an employee of a health care facility in which the principal is a patient if

the employee is providing direct care to the principal; or

an officer, director, partner, or business office employee of the health care

facility or of any parent organization of the health care facility.

You wouldn't know whether or not the document was valid unless you knew all

the parties and their circumstances.

The witnesses are not generally on scene. It is normal to get strangers to

act as the witnesses. So you wouldn't have any way to verify the validity of

the instrument.

What presumptions should you or could you make? Either that the document IS

valid or that it is not. The safest thing to do is to continue resuscitation

to the hospital and allow them to sort it out.

The scene of a code is neither the time nor place to check out a document's

validity.

GG

In a message dated 7/24/2004 9:34:58 AM Central Daylight Time,

FireMedic1633@... writes:

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?

Well, While your crew (Hopefully more than 2) starts working the code, One

person explains to the family (Both) the decision to start and then contact

medical control. All it takes is just one to get it started. Unless the one

saying no has paper work that says they are the sole decision maker.

Just my little old humble opinion.

Tom LeNeveu

Learning Paramedic

[Guest guest]

In a message dated 7/24/04 8:48:28 AM Central Daylight Time,

donnie7435@... writes:

> Now a days you aren't treating the patient, you are treating the lawyers....

>

and Trauma coordinators, and JCAHO inspectors, and the OIG, and the good

folks at CMS, and ...........

[Guest guest]

In a message dated 7/24/04 8:48:28 AM Central Daylight Time,

donnie7435@... writes:

> Now a days you aren't treating the patient, you are treating the lawyers....

>

and Trauma coordinators, and JCAHO inspectors, and the OIG, and the good

folks at CMS, and ...........

[Guest guest]

In a message dated 7/24/04 8:48:28 AM Central Daylight Time,

donnie7435@... writes:

> Now a days you aren't treating the patient, you are treating the lawyers....

>

and Trauma coordinators, and JCAHO inspectors, and the OIG, and the good

folks at CMS, and ...........

[Guest guest]

Most doctors will treat the lawyers who get them out of their speeding

tickets, handle their divorces and try to save their fortunes for them when

their

wife comes home early on Wednesday afternoon and catches them in bed with Nurse

Barbie, and who set up their corporations for them and show them how to hide

their assets in Grand Cayman.

GG

In a message dated 7/24/2004 1:29:07 PM Central Daylight Time,

lnmolino@... writes:

In a message dated 7/24/2004 8:48:30 AM Central Daylight Time,

donnie7435@... writes:

Now a days you aren't treating the patient, you are treating the lawyers....

God I hope not! Besides some in the AMA say that DR's should not treat

lawyers anyway right?

Louis N. Molino, Sr., CET

FF/NREMT-B/FSI/EMSI

LNMolino@...

(Home Office)

" A Texan with a Jersey Attitude "

The comments contained in this E-mail are the opinions of the author and the

author alone. I in no way ever intend to speak for any person or organization

that I am in any way whatsoever involved or associated with unless I

specifically state that I am doing so. Further this E-mail is intended only

for its

stated recipient and may contain private and or confidential materials

retransmission is strictly prohibited unless placed in the public domain by

the original

author.

[Guest guest]

Most doctors will treat the lawyers who get them out of their speeding

tickets, handle their divorces and try to save their fortunes for them when

their

wife comes home early on Wednesday afternoon and catches them in bed with Nurse

Barbie, and who set up their corporations for them and show them how to hide

their assets in Grand Cayman.

GG

In a message dated 7/24/2004 1:29:07 PM Central Daylight Time,

lnmolino@... writes:

In a message dated 7/24/2004 8:48:30 AM Central Daylight Time,

donnie7435@... writes:

Now a days you aren't treating the patient, you are treating the lawyers....

God I hope not! Besides some in the AMA say that DR's should not treat

lawyers anyway right?

Louis N. Molino, Sr., CET

FF/NREMT-B/FSI/EMSI

LNMolino@...

(Home Office)

" A Texan with a Jersey Attitude "

The comments contained in this E-mail are the opinions of the author and the

author alone. I in no way ever intend to speak for any person or organization

that I am in any way whatsoever involved or associated with unless I

specifically state that I am doing so. Further this E-mail is intended only

for its

stated recipient and may contain private and or confidential materials

retransmission is strictly prohibited unless placed in the public domain by

the original

author.

[Guest guest]

Most doctors will treat the lawyers who get them out of their speeding

tickets, handle their divorces and try to save their fortunes for them when

their

wife comes home early on Wednesday afternoon and catches them in bed with Nurse

Barbie, and who set up their corporations for them and show them how to hide

their assets in Grand Cayman.

GG

In a message dated 7/24/2004 1:29:07 PM Central Daylight Time,

lnmolino@... writes:

In a message dated 7/24/2004 8:48:30 AM Central Daylight Time,

donnie7435@... writes:

Now a days you aren't treating the patient, you are treating the lawyers....

God I hope not! Besides some in the AMA say that DR's should not treat

lawyers anyway right?

Louis N. Molino, Sr., CET

FF/NREMT-B/FSI/EMSI

LNMolino@...

(Home Office)

" A Texan with a Jersey Attitude "

The comments contained in this E-mail are the opinions of the author and the

author alone. I in no way ever intend to speak for any person or organization

that I am in any way whatsoever involved or associated with unless I

specifically state that I am doing so. Further this E-mail is intended only

for its

stated recipient and may contain private and or confidential materials

retransmission is strictly prohibited unless placed in the public domain by

the original

author.

[Guest guest]

Work it but watch your back.

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]

[Guest guest]

Work it but watch your back.

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]

[Guest guest]

Work it but watch your back.

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]

[Guest guest]

The two most lied about professions for emergency patients.

ED Clerk: " What is your occupation? "

Chiropractor: " Health care, sort of. "

Lawyer: " Landscaping "

Re: DNR Again

Most doctors will treat the lawyers who get them out of their speeding

tickets, handle their divorces and try to save their fortunes for them when

their

wife comes home early on Wednesday afternoon and catches them in bed with

Nurse

Barbie, and who set up their corporations for them and show them how to hide

their assets in Grand Cayman.

GG

In a message dated 7/24/2004 1:29:07 PM Central Daylight Time,

lnmolino@... writes:

In a message dated 7/24/2004 8:48:30 AM Central Daylight Time,

donnie7435@... writes:

Now a days you aren't treating the patient, you are treating the lawyers....

God I hope not! Besides some in the AMA say that DR's should not treat

lawyers anyway right?

Louis N. Molino, Sr., CET

FF/NREMT-B/FSI/EMSI

LNMolino@...

(Home Office)

" A Texan with a Jersey Attitude "

The comments contained in this E-mail are the opinions of the author and the

author alone. I in no way ever intend to speak for any person or

organization

that I am in any way whatsoever involved or associated with unless I

specifically state that I am doing so. Further this E-mail is intended only

for its

stated recipient and may contain private and or confidential materials

retransmission is strictly prohibited unless placed in the public domain by

the original

author.