Playing God

The call comes at 1:01 AM.

It’s my brother, Steve, calling to tell me that Mom’s blood pressure is 60 palpable. Despite my brother’s pleas that something be done, the staff and attending physician are adamant. “She has a DNR,” they insist. Steve can’t seem to persuade them that our mother’s wishes include the use of transfusions, pressors, and transfer to the ICU 3 floors below.

I phone the charge nurse. “Yes, we hold Mom’s durable power of attorney for health care,” I tell her. “But despite what your records may indicate, she does not belong on the DNR list.”

“Are you sure? We have a DNR.”

Absolutely sure, I respond, explaining that Steve and I are the ones who discussed Mom’s wishes with her before she was intubated and admitted to long-term acute care.

A few days later, as Mom’s septic shock is successfully treated, the intensivist applies pressure again. “This is futile. We should disconnect the ventilator,” he says.

“I am sorry, doctor, but that is not her wish.”

“But this is a waste of an ICU bed,” the intensivist adds—words that no doctor should ever utter to the family of a critically ill patient. We respond by threatening legal action and calls to the state medical board.

As time passes, Mom grows increasingly more lucid. Once again, she has narrowly escaped death. Barring a miracle, she will never see home again. Yet as best as we can tell, she continues to desire aggressive care, short of CPR.

Futile? Perhaps. But who are we to decide her fate?

I am not afraid of death squads. It is doctors playing God who frighten me.

The call comes at 1:01 AM.

It’s my brother, Steve, calling to tell me that Mom’s blood pressure is 60 palpable. Despite my brother’s pleas that something be done, the staff and attending physician are adamant. “She has a DNR,” they insist. Steve can’t seem to persuade them that our mother’s wishes include the use of transfusions, pressors, and transfer to the ICU 3 floors below.

I phone the charge nurse. “Yes, we hold Mom’s durable power of attorney for health care,” I tell her. “But despite what your records may indicate, she does not belong on the DNR list.”

“Are you sure? We have a DNR.”

Absolutely sure, I respond, explaining that Steve and I are the ones who discussed Mom’s wishes with her before she was intubated and admitted to long-term acute care.

A few days later, as Mom’s septic shock is successfully treated, the intensivist applies pressure again. “This is futile. We should disconnect the ventilator,” he says.

“I am sorry, doctor, but that is not her wish.”

“But this is a waste of an ICU bed,” the intensivist adds—words that no doctor should ever utter to the family of a critically ill patient. We respond by threatening legal action and calls to the state medical board.

As time passes, Mom grows increasingly more lucid. Once again, she has narrowly escaped death. Barring a miracle, she will never see home again. Yet as best as we can tell, she continues to desire aggressive care, short of CPR.

Futile? Perhaps. But who are we to decide her fate?

I am not afraid of death squads. It is doctors playing God who frighten me.

The call comes at 1:01 AM.

It’s my brother, Steve, calling to tell me that Mom’s blood pressure is 60 palpable. Despite my brother’s pleas that something be done, the staff and attending physician are adamant. “She has a DNR,” they insist. Steve can’t seem to persuade them that our mother’s wishes include the use of transfusions, pressors, and transfer to the ICU 3 floors below.

I phone the charge nurse. “Yes, we hold Mom’s durable power of attorney for health care,” I tell her. “But despite what your records may indicate, she does not belong on the DNR list.”

“Are you sure? We have a DNR.”

Absolutely sure, I respond, explaining that Steve and I are the ones who discussed Mom’s wishes with her before she was intubated and admitted to long-term acute care.

A few days later, as Mom’s septic shock is successfully treated, the intensivist applies pressure again. “This is futile. We should disconnect the ventilator,” he says.

“I am sorry, doctor, but that is not her wish.”

“But this is a waste of an ICU bed,” the intensivist adds—words that no doctor should ever utter to the family of a critically ill patient. We respond by threatening legal action and calls to the state medical board.

As time passes, Mom grows increasingly more lucid. Once again, she has narrowly escaped death. Barring a miracle, she will never see home again. Yet as best as we can tell, she continues to desire aggressive care, short of CPR.

Futile? Perhaps. But who are we to decide her fate?

I am not afraid of death squads. It is doctors playing God who frighten me.