Woman with "Right to Die" Tattoo May Be Out of Luck in Iowa.
By bluegal Monday Sep 10, 2007 6:02pm
From Strange Tales:
Mary Wohlford, 80, of Decorah, Iowa, had the words “DO NOT RESUSCITATE” tattooed on her chest [last year, tattoo shown above] to make her medical wishes clear, but at least one doctor thinks that isn’t enough to stop medical personnel. Dr. Mark Purtle of the Iowa Methodist Medical Center in Des Moines told the Des Moines Register that state law defines when caregivers are permitted to end life-sustaining measures, and a tattoo isn’t enough. Wohlford noted that she also has a living will hanging on the side of her refrigerator.
Update: Zennurse wrote a comment and added to it in a separate email:
"I'm concerned about the limits of the post; she has a living will on her fridge and that is where the EMT's will look for it if needed. As a retired nurse, she decided to have the tattoo done after seeing what happened to Terri Schiavo, but she has family who know about her living will and she is apparently aware that it will cover her in an emergency. As a nurse myself, I feel certain she knows the tattoo will not. I think what I'm concerned with is that after reading through the comments, I find no mention of the fact that
having a living will or advance directive is the best way to exercise freedom of choice, in fact that is where such protections came from.
(Kind of like the labor party bringing you vacations) I see this woman's choice as more of a snarky statement of despair at the state of healthcare in this country and the pretty rational fear of overtreatment out of fear of litigation should she be "found down", or have a medical event outside her home which renders her unable to make choices for herself.I'm glad you were prompted to post the petition link and have signed it. I just wish there had been a little more research into who she
was, why she did what she did and what the implications of it might be beyond a knee-jerk reaction that it was government out of control. I just don't think that's the case here.I'm a hospice nurse and understand all too well the risks involved. I have stood over patients to prevent CPR while waiting for family to deliver the correct paperwork and have also, in earlier days, done CPR on patients who had no hope of surviving because the family insisted on taking the chance. The basic premise of the post is correct, it is about choice, but it says more about the disaster that is healthcare in the country than some underhanded effort by the government to limit our freedoms."
This story just came to my attention today, and it seems timely to run this video from last year. The whole thing is good, but particularly the story from Lucy at 2:02.
An 80-year-old woman should not need a tattoo on her chest in order to protect her right to refuse resuscitation if she has made the choice of sound mind. There is a petition online that covers this and other issues at the First Freedom First website.
Login or Register to post comments.
Welcome to the "culture of life". Now back to Iraq..
I have always found this exceedingly strange.
In what way is it anyone else's business regarding whether or not you want to be resuscitated?
All the supposed xtians and fundies are completely terrified of death.
Except, of course, when it is the byproduct of a war of choice and aggression... then they seem to want to bathe in the blood.
Pete @ 2:
How true!
The Med Mafia wants to loot you for every penny they can extract.
An expat woman in Belize, recently was diagnosed with cancer. She was shipped back to the US by concerned family members where she died seven weeks later. Her parents carried a one million dollar limit health insurance policy for her. In six weeks the U.S. medical mafia consumed the entire million and left her so broke she could not even have hospice care during her last week of life.
If she had tatooed the word UNINSURED under the DNR, she'd have her wishes honored.
Free will is a Constitutional guarantee. Holy rollers that won't leave you alone are as disgusting as railing atheist as self righteous medical treatment.
My mother-in-law had a stroke last year and if my father-in-law hadn't been carrying the actual paperwork indicating her wishes (no extraordinary life-support), the hospital would have put her on machines (even with no brainwave activity). He had to forcefully indicate, several times, her wishes and that he was the responsible party carrying out her wishes.
She was transfered to a hospice facility and passed away peacefully and with dignity, surrounded by her loved ones.
That is the way it should be.
Pete @ 2:
As a civil libertarian, I agree. I would only point out that when a person's life or health are in danger, and a doctor is around, I think the doctor has the right to (and should) presume that the person does want to be rescued/saved/resuscitated. In other words, I think it is sensible policy to require those who do not wish to be resuscitated to make their wishes official and clear. Whether a tattoo would count should count as a legal formality can be open for debate, I suppose. But as long as a person's wishes are clear, those wishes should be respected. It's not the government's business at all.
The whole anti-abortion and anti-right to die thing stems from a Biblical passage which says that only God should sort out who is born and who dies. But of course, this doesn't seem to cover when they mass murder people, and of course, it doesn't cover the question "what if God assigned Dr. X to kill someone who's terminally ill?"... it reminds me of this joke:
An old devout Christian lived near a river, and after several days of rain, the river flooded up to his front door. A park ranger pulls up to his house in a Jeep, and tells him to evacuate because the flooding will get worse. The old man replies, "I'm not worried because God will take care of me."
The flood waters rise up to the second floor, and he goes upstairs and hangs out in his bedroom. A deputy pulls up in a row boat and tells him to evacuate. The old man replies, "I'm not worried, as God will take care of me."
The water continues to rise, and he gets out of his house and on to the roof. A helicopter comes by, drops a latter, and the sheriff yells on his bullhorn, "Get out now!" The old man yells back, "God will save me." The sheriff gives up and flies away.
Eventually, the water rises, and despite all his praying, the old man gets washed away and drowns. He arrives in Heaven, and asks God, "I have served you for my entire life, and you did not save me when I needed you." God said, "I did try to save you... I sent you a park ranger, a sheriff and a deputy to rescue you, but you refused my help."
Dotty Gale @ 5:
Excellent point! And that would make for a great political cartoon: Juxtapose two frames -- one patient surrounded by the Sanctimonious Right who insist upon resuscitating her against her wishes; the other refused treatment by hospitals and tossed into the streets to die because she had not insurance.
The Sanctimonious Right is not pro-life. It's pro-suffering.
But America was founded as a Christian nation...
God decides who gets the love and who doesn't. I say give 'em the love.
Then when the glory boys come... well that's a different story!
We are not American citizens any more, we are American CONSUMERS. You have a right to die only when you can no longer purchase medicine and other 'luxuries.' Until then it is soverign duty to remain alive and keep the product moving, whether you like it or not.
Strangefate @ 12:
Consumers and cash cows to be milked.
so now their telling little old ladies what they can and can't do with their own bodies.......fundies...
Karen @ 10:
Well, that's not very Buddhist of them. Oh yeah, right... this is a "Christian nation". :roll:
Strangefate @ 12:
Yep...you got that right......well said.
I'll respect people's wishes... but why in hell don't you want to be recessitated?
I mean, I can see not wanting a feeding tube or be kept alive on life-support or in a vegetative state... but why would you not want to be recessitated?
jake3988 @ 17:
For some, it's because they're suffering from very painful, terminal diseases. When the disease finally stops their hearts (or the like), some would rather that simply mark the end, and not fight through the pain. Very often, reviving them is easy -- for the doctor. Restarting their hearts, for instance, is not necessarily a difficult thing to do. But it can be painful just to be resuscitated, and many would rather not go through it several times just to prolong the suffering from a disease that will take their lives anyway.
For others, they're simply elderly, have lost many of their faculties, and are ready to go. We have plenty of technologies to prolong life, but not always at what a particular person would regard as sufficient quality.
Ultimately, death is not optional. We'll all die. And people want to be in control of how they die.
jake3988 @ 17:
Resuscitation is not like on TV. A small percentage of people are "brought back" and a good number of them suffer permanent and serious physical or neurological issues. DNR are normally issued/requested when the patient has a severe or inevitably terminal condition. It comes down to what a person considers their potential quality of life is after resuscitation.
The medical establishment: America's new gods.
Makes you want to stay awake just so you can tell all the religious do-gooders and human rights invaders to fuck off.
My DNR would be conditional: "Resuscitate to hear a message from the owner"
My 90-plus grandmother had a DNR order because she was old, frail, in a nursing home, and if she went into cardiac arrest, she wanted to move on to whatever SHE believed was waiting for her after death. It was her choice (she was lucid and not suffering from any dementia, thank goodness).
Her individual choice.
When the religious beliefs of OTHER legislators, churches, preachers, and yes, doctors and pharmacists, take precedence over the right of a right-minded individual to make their own life or death health care decisions, that is un-American.
I don't think this is a liberal or conservative issue. I think it spans all political attitudes.
If you haven't signed the First Freedom First petition linked above, I want to ask. Why not?
every jolly republican's dream to have the government decide such things... government knows who should live or die... people or families are second.... government defines morality... thats republicanism!
following through with the story, she does have a living will, which will cover her in Iowa. She is a retired nurse and knows what can happen in an emergency; the living will on her refrigerator tells me she knows that that is where EMT's will look first for it. It is also very helpful to have a health care proxy, a legal document which defines who can make decisions for you in case you are incapacitated, and to have a clear and serious discussion about what your wishes are.
As a Hospice nurse, I deal with this all the time, and frequently discuss with patients and families thier desires and wishes about end of life issues. As to the person who can't understand who anyone wouldn't want to be resuscitated, there are many people in our country who have terminal illnesses for whom resuscitation would be pointless. they are living lives of pain, steadily declining ability to care for themselves and increasing need to have medical procedures and take many medications to help them live with some kind of quality. These are not just 80 year olds, one of my patients, a 40 year old woman with lung cancer which had spread to her bone, liver and brain, died peacefully last week without resuscitation, which was her choice. Another group is patients with diseases like ALS, or Lou Gehrig's Disease, which slowly takes away a person's ability to move, swallow, and eventually, to breathe. Some patients choose to live with feeding tubes and respirators but some do not and this is a resuscitation issue as well.
I encourage everyone to look at what will be legal coverage in your state and institute it for yourselves. Encourage your loved ones to do the same. If you are dealing with a terminal diagnosis or severe, unrelieved pain, look for help from either Hospice (terminal care) or a Palliative Care team. This is the way to exercise your right to have a choice about how you die since, I promise you, there is little choice about when.
zennurse @ 23:
Excellent points.
I read through the comments to be sure this hadn't already been addressed. Let me preface by saying I was a nurse for 10 years, and am in medical school. Also, I firmly believe that a person has a right to choose death with dignity.
That said, A tattoo is not a legal document. If a patient comes in and is in critical condition, but can still make their wishes known, then the staff should and is legally obligated to follow them. If the patient is unable to make wishes known, they are obligated to extend all measures possible unless a living will is on file or a legal power of attorny (legally designated decision maker) is present. These rules are designed to protect a patient, emphatically NOT to strip them of their rights or to bleed their money off.
Since the DNR tattoo is not a legal document, if a Doctor did not resuscitate and the patient's family sued, that Doctor would lose their license and the "good" doctor would no longer be able to help patients at all.
Good physicians respect their patient's wishes WHEN THEY ARE KNOWN but if you don't know...you are not allowed to parse...you have to save them by any means necessary. This prevents a "bad" doctor from making arbitrary decisions based on race or class or whatever. Theoretically.
Reality is that the world is fuzzy. But I know exactly what I would do. I would save her and then go home and cry. Because no matter how hard you try, sometimes (most of the time) you just can't figure out the right answer.
What I don't get is that on one hand they are all God, God, God, but when God makes the decision to take someone they want to stop it. Makes no sense. It's not about religion because if it is they are defying God's wishes, so to speak.
It's not unamerican, its inhumane.
The Republican mantra: "We force those who want to die to live and those who want to live to die." It's the Republican way, bass ackwards like everything else they stand for.
When my Mom was going through her end of life situation (young only 67) she often joked about getting that very same tattoo. Luckily she was prepared with all tghe legal documents she needed us to have when that time came. She passed quitely with her famliy around her so we did not have to face that particular fight.
ZennNurse
Ma was in hospice the last 6 months of her life and we got to know the nurses and staff very well. THANK YOU for what you do.
it's pathetic that this kind of video needs to be made in America, Americans should know better but the "Compassionate Conservatives" aren't compassionate when it comes to things that require tolerance. I don't understand why anyone would think that what someone else does with their life is any-ones business but the individual who's life it is. It's nobodies business who you pray to, if you prey, what you do with your life (as long as it doesn't physically effect someone else). It's nobodies business who you love, where you live or what goes on inside your home (as long as it stays inside it should be off limits to anyone outside) but the Moral High-Grounders who never have had a single true moral in their lives will tell you you can't end you own life because it's against my beliefs! What the fuck is that?!? I understand you want to help someone who is misguided and can live a fuller life, but if it's someone who hasn't been out of bed in 16 years...do the right thing and stay out of their family's affairs.
and 28 pidomon, you are right on the money, the people who work in hospice are amazing and if anyone is to have the blessing of Jesus it's the staff who work hospice and really help people to cope with what is a very tough time. Same goes for ICU staff, just amazing. Bless you all. (and I'm an atheist! so for me to say that :) )
Dahgrostab’ph-r-i
Amen brother/sister! :)
The medical establishment loves to keep people who have coverage alive as long as possible. They make lots of money while doing so.
What is really despicable are the politicians who profess their religious beliefs only to get the religious right vote which is at the core of the problem here. Many of these turn out to have committed crimes or are committing crimes that is considered against their religious doctrine. Hypocrites to the core but then the people who share their beliefs suddenly find their compassion and tell us that we are over reacting when we demand justice even when it involves molesting a child.
I shouldn't have to consult a religion that I don't believe in nor should I be subjected to laws that are based on this same concept if I choose to allow myself to surrender to a disease that is too painful or costly to fight. Particularly when the U.S. is (apparently) governed by a Constitution that prohibits allowing religion to play a role in that decision.
This is one of the cancers that is spreading and killing the original concepts of the U.S. Constitution. I don't have much hope that it will stop because those destroying it and those keeping them in power don't care about what is and what is not considered lawful as our Constitution stipulates. And they have the power until it gets taken away and that will have to be done quickly and decisively before it is too late.
I have seizures so I can't drive, and I have to bike or walk everywhere. When a seizure hits and leaves me convulsing by the side of the road, someone always calls 911 on me and an ambulance takes me to the ER.
Recovery from seizures is always worse when this happens- they tie me to a gurney for observation which always makes me choke and gag and have trouble breathing. What I have to do the most is go to bed and sleep for 18-24 hours. If I'm in the ER I can't do that, and my wife has to go there and do the song and dance all day trying to track down the doctor on call who won't show up otherwise. Then when he does, I get a very expensive diagnosis of epilepsy (like it says on my medical bracelet that nobody reads). If I'm uninsured when this happens, I really get screwed financially. Even with insurance there are financial repercussions if I tell the ambulance to take me home AMA instead of going to the ER. So I'm forced to go through a needlessly traumatic recovery in the ER for insurance reasons. I'm thinking of getting a bracelet that says "do not call 911" or "medical treatment refused" and listing my wife's cell phone number. (The one I have now says "EPILEPSY see card in wallet" and I say that stuff on the card.)
I called the ambulance companies and they said that once the 911 call comes in from someone driving by, this will not work. The ambulance is legally required by CA state law to take me to the ER unless I refuse to give consent AMA which causes problems with insurance. And if they don't believe I'm capable of making decisions, what I say isn't taken seriously anyway. They never take me home.
So I basically can't afford to go outside by myself anymore. I always have to worry that our stupid health care system might swoop down, pick me up, and charge me a couple hundred bucks.
Millionth Monkey...I am sorry to hear about your condition. It can't be easy living under those conditions. But, your complaint is flawed. You are complaining that if you end up "convulsing on the side of the road", "someone always calls 911" and our "stupid health care system" takes you to the hospital. Guess what? That is the way a good system works. I would hope that if anyone is seizing in public, 911 is activated by bystanders, and the paramedics take you to the hospital. I can't even understand how this thread got so off topic, but to hear people complain about paramedics doing their job is disheartening.
Let's cut to the chase. They most likely tie you to the gurney because you are combative from your seizure. They are protecting you from hurting yourself or from hurting someone else. They take you to the hospital because that is where paramedics transport people. They don't take people home...doesn't work that way. They will let you sign out AMA (against medical advice) if you are alert and able to answer simple questions...like your name,where you live and what day it is. If you can't do that, guess what, you need to be evaluated by a doctor. That's a good thing. That protects everyone, including you.
As for the lady with the DNR tattoo...it is pretty simple. First, get a good signed original DNR document and keep it with you. Second, get a DNR pendant or bracelet and wear it. Third, tell the folks you live with or take care of you where your paperwork is if something should happen and you need to show it to medical personnel. Paramedics are constantly called to take care of hospice or terminal patients that don't want to be resuscitated by their scared or frantic family members or care givers. If the paramedics show up and there is no paperwork, generally they are obligated to treat. If I show up and see a tattoo that says "do not resuscitate", it is not a legal document and I will treat the patient, but it will definitely make me take a good look around to see if there is actual DNR paperwork nearby.
This system is designed to protect people. It is not a left vs. right thing.
pro life should be called "pro control" because they need control over the population to feel a sense of purpose in their hollow lives
Blue Gal, this absolutely demonstrates the need for everyone to add their name to the First Freedom First petition. The FFF organizers want to demonstrate the overwhelming support for PERSONAL FREEDOM in important matters such as end of life decisions. PLEASE, PLEASE, PLEASE go to the FFF web site and sign the petition.
BAC
pidomon @ 28:
Thanks, I love what I do and will accept your gratitude in the name of all of my colleagues. And thanks to C&L for the addition to the post. I hope it will move a few folks to follow through with the suggestions I made.
I remember the first time I heard a nurse joke about the DNR tattoo. I was 18 (34 years ago), a new nurse's aide at my local hospital , and had already seen enough to agree. It isn't a new idea, it's just sad that we have not progressed to the point where such a notion is history.
emser @ 33:
The system is designed to "disincentivize" you from having a chronic medical condition. If this is working as "designed to protect people" then what do you suggest I do to avoid getting driven into bankruptcy by hundreds of seizures? Trying to set up an arrangement with the local ambulance services doesn't work. It doesn't matter whether it's the first time, the second time, or the hundredth time- the law mandates the same stupid response no matter how familiar everyone gets with the situation. Signing out AMA means no insurance coverage and full price charges for the ambulance itself. That's a four digit bill. The only solution I can think of is to emigrate to another country where this type of medical condition doesn't automatically mean financial ruin.
Silly people.
Everyone thinks it's their life.
Don't you realize that we're all just property of the ruling class?
Kinda of like cattle, or sheep, we belong to our benevolent "shepards", who have only the god-ordained best for us in mind. That's why suicide is illegal.
They, in their enlightenment, should have the entitlement to tell us How to live, Who to love, and How to breed. As well as work us to our death...
Amen.
Two points:
1. Maybe the tatoo should read. "check fridge for living will" - sounds like a joke, but maybe it's not.
2. My son had a DNR in the last month of his battle with cancer - he was 10. We were able to sit with him in our bed where he was conceived and let him breath his last breath. When it is time to go, you know it.
i am from decorah & know that both of mary's sons served in vietnam. one came back injured for life and the other not at all... i had never heard the story about her tattoo ... i will have to ask her son about it... he is my sister's neighbor.
Dude, it aint easy tattooing a living will with all the legal fine print on your chest, and then embossing it.
jake3988 @ 17:
I understand your point but as someone who watched my grandmother die of cancer, i would also understand someone not wanting to be resuscitated as well. there are people who do not want to die but do not want to teeter the line between death and life for years before doing so.
In addition to all the above statements, I would never have a living will either. I would chose someone who I believe would carry out my wishes, make them well known to my loved ones, and give one person power of attorney to make medical decisions for me. My aunt is a nurse and someone she knew died during routine surgery because her living will prevented the doctors from repairing the vein they nicked.
Pete @ 2:
You sir, are a giant, festering asshole. Just something to consider before you write your next idiotic message to Teh Intrawebs.
If she had tatooed the word UNINSURED under the DNR, she’d have her wishes honored.
As a cardiologist, this issue comes up often as people have heart attacks that leave them brain dead or close to it. Too often we want to let the patient go, because we know they will not be able to come back, but we are limited by:
1. Families who "want everything done", even though that just amounts to an extra week or two of suffering for the patient before they finally succumb.
2. Lawsuits by family members who say we didn't do everything before stopping.
3. Family infighting because some know the patient wanted to go when it was their time, but other family members want to hang on.
People *must* understand that a living will really is meaningless to me as a physician standing over a patient who is actively dying. If you have ever read them, they use such vague verbiage to define when it is OK to invoke them. For instance, they refer essentially to irreversible disease processes. Unfortunately, the terminal words like "irreversible" used in all living wills are heavily opinionated -- you will always be able to find that one doctor out there that thinks they may have been able to bring the patient back if they had done that one extra step. So, that means the doctor is open to litigation, because the living wills are too vague. I *strongly* suggest you go over your living will with your physician as well as your lawyer, but most importantly, go over it with your family! The family is who we call when we have a question, not your lawyer and frequently not even your doctor -- there's typically no time.
Please understand I can keep your body along long after your mind has gone, but is that really how we should live? Of course not. The things I have to do to people's bodies to keep them living is practically vivisection and it sickens me when family insist on our tormenting their dying loved ones. As sick as this sounds, sometimes it'd be nice to make the family member experience just what we have to do to their family member before they insist that we do everything.
This says nothing about the cost of the intensive care unit to our society. It costs thousands of dollars daily in the ICU's, but many are concerned The Man is sticking it to them if they are not offered everything. Think of how much better that money could have been used on prevention or lowering other costs.
Finally, if you have a loved one for whom you are making decisions, don't project your own feelings into your loved one. When we ask family if it's time to stop, we're not asking what you would want for yourself. We're asking you as family members to convey what your loved one would have said if they could speak for themselves. So many times people wouldn't want us to prod on if they new they wouldn't be brought back to a meaningful life. Please understand it's ok to attempt to return a person to their best recent functioning over a short term (e.g. 2-3 days), but sometimes it's best to let nature take its course. Be sure to get palliative care physicians involved early, as they have refined the process of interacting between the doctors trained to maintain life and the family uncertain of when it's ok to let their loved one's life go.
I am a xtian, probably a fundie by y'alls definition, pro-life, pro-gun and probably pro twenty or so other things that make me ingratingly awful to readers on this site, but I think a DNR is a good idea, and I'm not scared of death at all, when the time comes I expect I'll put a DNR on for myself, but at 24 I hope to enjoy being around for a while. Just FYI (for y'alls information, look Texan too! another strike!) there are xtians out there who aren't hypocritical, who actually read and try to live by Jesus' example, instead of pigeonholing all of "those religious nuts" in one bloody, hateful hole try and look a little closer to the new friars in urban areas living in poverty just to help the neighborhoods, or the xtian enviromentalists fighting to curb global warming (arocha, evangelical climate initiative), those campaigning for global justice, check out groups that radically redefine the materialist hyper-conservative xtians of the last 50 years (intervarsity, ifes). There I've had my soapbox, proceed with ridicule if necessary, oh and for turning the other cheek you can harass my old email falconian@aol.com
I think the tatoo is the right idea. I didn't have any luck getting my father's living will honored - it took 4 days of calling various doctors before I found one willing to do the right thing. Total nightmare. Where else are you supposed to keep the thing?
L.A. Confidential @ 4:
Medicare pays for hospice - we received NO bill
jake3988 @ 17:
I know why my Mom had a DNR - she was in the final stages of lung cancer, and when her heart stopped, she felt it was time. When she did die, the Hospice aid didn't have to roll her over, and start CPR, call 9-11, bring in the fire Dept and ambulance, have her rushed to a hospital, all to be declared dead. The aid just felt for pulse (none) and called for the MD to pronounce my Mom - no panic, and she went with dignity
It would be easier to just legalize suicide and hand these DNR folks an antifreeze cocktail.
If she had tatooed the word UNINSURED under the DNR, she’d have her wishes honored. Hospitals are a big blood sucking vermins, they overcharge patients far more than they actually need. Just like diamonds being controlled by 1 family in the U.S. Just ridiculous.
Login or Register to post comments.