Orders Not to Resuscitate: Dilemma for Acute Care as Well as Long Term Care Facilities

But see Brown N.K. Thompson D.J. , Nontreatment of Fever in Extended Care Facilities, New England Journal of Medicine 300:1246–50 (May 31, 1979).

In re Quinlan, 355 A.2d 647 (N.J. 1976).

Superintendent of Belchertown State School v. Saikewicz, 370 N.E.2d 417 (Mass. 1978).

For an indepth discussion of these two cases, see Annas G.J. , Reconciling Quinlan and Saikewicz: Decision Making for the Terminally Ill Incompetent, American Journal of Law & Medicine 4(4):367 (Winter 1979). The highest court in New York has recently decided two cases together without citing either Quinlan or Saikewicz. Eichner holds that an incompetent patient in New York does have a right to refuse treatment by a prior declaration made when he was competent. Storar uses a mechanical view of prior blood transfusion cases to require that transfusions be given to a mentally retarded, terminally ill patient. In re Storar, 420 N.E.2d 64 (N.Y. 1981). For discussion, see Annas G.J. , Help from the Dead: The Fox and Storar Cases. Hastings Center Report 11(3):l9–20 (June 1981).

In re Dinnerstein, 380 N.E.2d 134 (Mass. App. 1978).

Id. at 139. See also, Glantz L.H. , Post-Saikewicz Judicial Actions Clarify the Rights of Patients and Families, Medicolegal News 6(4):9 (Winter 1978).

In re Spring, 405 N.E.2d 115 (Mass. 1980) (emphasis added).

See. e.g., Do Not Resuscitate (DNR) Guidelines, Minnesota Medical Association, Approved January 24, 1981.

This is consistent with recently updated standards. See Standards for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiac Care (ECC). Journal of the American Medical Association 244(5):453–509 (1980).

This was the approach adopted by the court in Dinnerstein. supra note 5, at 139, n. 10.

In the one known case where an active DNR order was challenged, the order was struck down because the guardian of the incompetent patient did not clearly understand its significance. Hoyt v. St. Mary's Rehabilitation Center. No. 774555, (Dist. Ct., 4th Jud. Dist., Hennepin Co., Minn. February 13, 1981). See Annas G.J. , Orders Not to Resuscitate: The Sharon Siebert Case, Nursing Law & Ethics 2(5):3 (May 1981).

See, e.g., Petition of J ones. 433 N.Y.S.2d 984 (N.Y. 1980). In some states, the definition of brain death as legal death is contained only within organ donation statutes, and this has caused some confusion about the pronouncement of death. See, Bacchiochi v. Johnson Mem. Hosp., No. 256126 (Super. Ct., Hartford/New Britain, Conn., March 13, 1981) (physician refused to withdraw respirator from brain dead patient who was not an organ donor).

In re Spring, supra note 7.

Commonwealth v. Capute. Bristol County Super. Ct., Massachusetts, October 22, 1981, Nos. 6828 (murder charge) and 6829 (unlawful dispensing of controlled substance).