Suggested euthanasia

On a legal point one adult cannot sign consenting or make decision for another adult. It makes medical teams feel better when the persuade relatives to sign forms on behalf of their loved ones but it's just plain wrong even if you sign a form yourself you can at any time rescind that decision as long as mentally competent to do so. Consent or refusal do not have to be on a signed form. Weight is given to an advanced directive ( there are forms for this online) given by a person to someone, best your GP or NOK, but even then a medical person can make a different clinical decision at the time. I have not signed an advanced directive, or living will myself as you can't predict the circumstances at the time it's needed. I certainly would not agree to a DNR but might agree to refuse extraordinary means.

DNR is not euthanasia. Euthanasia is an active ending of life without the person's consent. DNR is simply a lack of resuscitation when the person suffers a condition from which they would die without resuscitation. I think it's important that the two are not confused.

It is worth remembering that cardio-pulmonary resuscitation (CPR) is quite a brutal treatment and often not suitable for people suffering serious conditions like COPD. The doc will have been fully aware of that. I think the DNR note is a way of telling other medics and paramedics this. It does sound as if the suggestion was made rather bluntly though.

Dying Matters/Dignity in Dying also covers assisted suicide which is different again from euthanasia because it is the patient's choice and the patient's choice only.

This was a ham-fisted way of dealing with a delicate question. I don't think it was an offer of euthanasia though. Doctors aren't trained in these matters and it sounds like he was trying to be tactful but failed. Even if there is a DNR form it can be destroyed...

If the doctor concerned with the admin for your aunt's discharge had also been involved in her care, it would have been much better to discuss the issue with her and give her time to think about it while she was still in hospital. If he was just the one filling out the appropriate forms, it was truly crass, thoughtless and very unkind.

'The art of dying needs more respect and professional assistance rather than being regarded merely as a failure to live'

Dr Quentin Spender,

GPs these days are expected to identify the 1% of their patients that they expect to die within the next year, and have "the discussion" with them.
My husband had had it with his family and every GP/doctor/surgeon that he met in the last ten years of his life.
He acted on it in his last 3 weeks. He was 65.
Perhaps the doctor dealing with the discharge thought her GP had discussed it with her.
There's a website called Dying Matters where you can find out about all this.
I agree with the doctor, I'd rather just slip away in my sleep, like my mother did, instead of in hospital like my father, or in an old people's home like my aunt.

Gill.

I don't find it particularly 'disgusting' as the doctor may be thinking ahead for your much loved Aunt. We are heart over head whereas he/she would be head over heart.

I do however feel it was not a response that has been typical of the care from doctors and hospitals my dear father had encountered up to his end of life in June last year. Quite the contrary he had a pace-maker fitted at the age of 94.

It is an upsetting situation and maybe you or your Aunt should feel empowered to discuss this with the doctor and clarify that he/she must not assume what his/hers perception of your Aunt's remaining years will be like, are not the same as your Aunt's. I would think your doctor would appreciate your honesty and give appropriate consideration to your Aunt's feelings and future care and welfare.

That is Disgusting. It might be something to be thought about at a time when the patient is relatively well and really alert a truly "advance directive" but it really depends so much on quality of life of the individual level of pain or distress etc.

My last Aunt died at 96 after being in and out of hospital over a short period with several chest infections and UTIs. She was the very frail and quite confused. There came a point where my cousin had to decide that any more aggressive treatment was inappropriate.

my mother passed away in 2009. "One" of her medical conditions included the dreaded COPD. Mum decided, as her quality of life was indeed very poor, that she wanted a DNR. I am grateful that the approach by the medical team was done with great kindness. I think it wise to have a conversation with the consultant in charge of the care of your Aunt to not only to make him or her aware of the manner in which your aunt was approached but also to ensure that her medical records reflect her true wishes. if it was the consultant, ask to speak with medical Director.

This is disgusting and totally inappropriate.

I wish your aunt well.

Bell

Oh, I certainly agree with you there, Eleothan. I wish there were more options for terminally ill people, or for those who are just worn out by illness and would rather not struggle on. But it must be their choice, of course.

After 3 days on the senile dementia ward of a nursing home recently, I would definitely be NTBR and I have made it clear to my children.

My feeling is that such a discussion should only be entered into if the patient him/herself has indicated that they've had enough and do not wish to have a particular treatment or to be resuscitated. What right has anybody to suggest that a person's life isn't worth living - surely it is for that person alone to make such an assessment?

When someone is relatively young and healthy it is easy to make blithe statements about what they would do if they got old and ill - it is a theoretical matter that seems a long way away. It would be interesting to see if such people maintain such a stance when they are old and perhaps failing in health and whether they would appreciate assumptions being made about their quality of life.

Reminds me of many years ago when my 87yr. old grandfather had to have a leg amputated. He wasn't terribly well after the op and my grandmother was asked to sign a DNR form. As the pen in her hand hovered over the the paper she heard the words, "Don't you bloody dare, Elizabeth." Grandpa lived for another three years and there wasn't a single member of the family who didn't love pushing him around in his wheelchair.

My father (then 93) was asked in hospital if he wanted to be resuscitated and he was totally shocked - he thought he was in there to be cared for and cured!

I an see the other side of this - it is helpful for the team to know what someone's wishes are.

But there are ways of going about this that are not offensive and discriminatory.

He did seem to be suggesting that AuntieJ must have considered it, though! It does seem a very odd and inappropriate comment for a doctor to make.

Of course, strictly speaking, the doctor however crass, wasn't suggesting euthanasia.

Well, if you can't be given the benefit of the doubt re bed blocking, Galen, there's no hope for the rest of us.

Sorry, that should have been 95yr old mother.

Disgusting!
I was upset to be told they could t keep me in overnight in the hospital when I dislocated my shoulder and was so full of morphine and fentanyl I couldn't even stand without help.
The reason given by the A&E consultant:- I would be a "bed blocker"!
I'm 69 and although disabled, self caring and still working!

Did your aunt or next of kin sign it, Gill? When my 9 yr. mother was issued with a DNR certificate after a chest infection I had to sign it. That was a year ago and she's still going strong.

shocking!! and disgusting.this lady J could and Im sure will have many more happy yrs ahead of her.
Brings me back to the time when DH had heart bad heart attack! when they brought him back round they pestered him to make a decision as to DNA they said it if he had another heart attack it would leave him like a cabbage! so off course feeling rotten and couldn't care less he agreed DNT (this was whilst I was not there)!! they said he would most likely have another heart attack within 24 hours.! well!!! that was over 5 yrs ago!! and he is still here...yes in very bad health now, but once he did recover from that heart attack he enjoyed the time until he became ill again...so.........there you are who are they to judge! huh!

That sort of casual ageism deserves to be challenged and I would most certainly write to the doctor concerned with a copy of the letter to the hospital NHS Trust. Shameful!

That's shocking Gill! Your Aunt sounds as if she's doing quite well for her age & still enjoying a good quality of life. How dare he more or less suggest that she should go away & die! Absolutely disgraceful to make her feel like that.

I don't think they teach bedside manner but if they do, this doctor seems to have been off school that day. He's obviously made a completely unfounded assumption about your aunt and there is absolutely no obligation on her part to carry a DNR letter with her "just in case". He really should have a good slap but it's almost certainly not worth the effort making a complaint.

Good on you auntie – keep up the way of life that works for you.