Econstudentlog

Danish death panels

Mostly to the non-Danish readers. It seems there’s recently been a story about widespread use of secret DNR-codes by Danish doctors, I haven’t been able to find an article about it in English but here’s google translate. The doctors apparently systematically write in the journals of some sick people that nurses and staff should not try to save the individual in case they have a heart attack. In some cases, the code states that they shouldn’t be put in intensive care.

There’s been zero debate about this before this story broke, it was just something doctors did. A study from 2007 that apparently now has come to some journalist’s attention found that whereas almost all departments use the ‘no resuscitation in case of heart attack’ (natural enough, some people want to avoid becoming a living vegetable and people are given the choice) one third of all medical departments (n= 138) use these codes in secret, where the doctor makes the decision, often without informing the patient. 38 percent of the departments uses the codes in cases where the individual is not terminal.

Another article – which google translate translates into something that makes absolutely no sense – makes it clear that the practise is illegal, as it’s currently (on paper) illegal to decide whether a patient should be attempted resuscitated or not without informing the individual. The doctor actually can decide you should not receive treatment, but he has to inform you about the decision and your response to the decision should be put into the medical chart. I didn’t know that you could be denied resuscitation attempts but it doesn’t surprise me.

I think the health care system is one of those places where people sometimes can convince themselves that it’s better just to pretend tradeoffs don’t exist, because then they don’t have to deal with the ethical dilemmas which are all over the place. But the tradeoffs don’t go away by pretending they do, and somebody has to make some hard choices at some point. If nobody else do, the doctors have to; if everybody else just ignore the incompatibility of the current political demands (the laws) regarding medical service provision and the ressource constraints that exist in the field, well, the doctors are pretty much left with the bag.

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January 17, 2011 - Posted by | health care

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