Being Human

We’ve had some, uh, spirited conversations around the dinner table this week about CPR.

I was shocked by two ideas.

1. Assisted living facilities, such as the one in Bakersfield that is the subject of national news this week, often have corporate policies that preclude employees from offering potentially life-saving aid.

They don’t want their clients to die, really, but they REALLY don’t want to be sued.

We don’t really know what happened at the facility in full detail … it is certain that a woman called 911 from the facility, and then she refused to render aid when prompted by the emergency dispatcher. She stated this was against policy.

Not a human policy, a corporate policy. Not a law, a corporate policy.

I have read the caller was a certified nurse of some kind, but working in a non-nursing role at this facility. I have read that the patient had a “DNR” (do not resuscitate) on file, and I’ve read that she didn’t have one on file. Don’t know … and ultimately, I don’t care. The facility employee didn’t have her ethics working properly this day, and the corporation that employed her doesn’t have a heart. Clearly.

2. School districts in California often have policies that preclude teachers from offering potentially life-saving aid. Teachers cannot do CPR, even if trained (in fact, they must be trained, and then often are told not to use that skill by District rule). EpiPens cannot be administered by a teacher in a classroom, even if the student is choking from a bee sting or other allergic reaction.

Schools don’t want their students to die, really, but they REALLY don’t want to be sued.

I find this an offensive situation. School teachers should be trained in first aid. School teachers with special needs kids in their rooms (such as those requiring EpiPens) should have advanced training. And then they should be authorized to use that training when required.

It’s the human thing to do.

I was not shocked by a third idea.

3. CPR does not work all of the time … and it seldom works with old, infirm people.

Read the Alabama ER Doc’s opinion on this one (link is below). Personally, I know that emergency CPR doesn’t work all of the time … but if it’s the best first aid we have available, don’t you think we should use it, assuming it is consistent with the patient’s wishes?

Liability?

From CNN.com:

Dr. Graham Nichol, a professor of medicine at the University of Washington, said he was shocked by what happened (at the Bakersfield assisted living facility).

CPR doubles survival odds, he said.

“If liability was a concern,” Nichol said. “I would suspect there is a greater liability if someone dies.”

Actually, I’m not sure that’s true. But I do know what the human thing to do would be.

Most states have “Good Samaritan Laws” that protect citizens that act in a reasonable way, consistent with their training, to help other people in emergency situations. Because we are such a litigious society, those laws are often tested in court, and good samaritans are still sometimes sued because they attempted to render aid. There was a famous 2009 case in California, where a woman dragged a victim from the victim’s car after an accident … and the victim was then a paraplegic after the accident. The California Supreme Court found that the “aid” given by this samaritan was inappropriate, and resulted in injury to the victim. Clearly, “good” samaritans can do too much, and too much is not “good.”

It’s also true that you can be sued at any time for doing anything, or for doing nothing. Good samaritan laws are intended to protect citizens, and encourage them to help one another. Those laws are intended to be a legal shield for people like soccer coaches or Scout leaders who help the young people in their charge when they are injured.

Doesn’t that sound like a good idea?

What You Should Do

Are you CPR certified? Your local Red Cross probably offers first aid and CPR training. Get certified, and then you’ll know how to properly deal with emergency situations within your family and in the workplace. You should know what to do, shouldn’t you?

Make sure your wishes are known for how you want care administered in situations where you are incapacitated. This is particularly important for people in extended families, having distant relatives, or in unique living situations. If you don’t make your wishes known, then your next of kin WILL make those decisions for you if they are REQUIRED to do so by circumstances out of everyone’s control. Note that health care professionals do NOT make these decisions. Family members do: not life-long companions or really good friends. And, if there are multiple children disagreeing about what to do when their parent is gravely ill … then that parent may not be treated the way they would wish to be treated.

If you want to make sure your wishes are carried out, you need a POLST. Note that different states have different forms, but here’s the link for California: