Saga of Texas man emphasizes need for DNR consent law taking effect on Sunday

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Until now, Texas law has been silent on the life and death issue of whether hospitals had to secure consent from patients or surrogates before issuing Do-Not-Resuscitate orders (DNRs).  Due to lack of clarity in the law, individual hospitals set their own policies regarding DNRs, some requiring consent, some suggesting post facto notification, and some with no policy.  In decades of patient advocacy and working with Texas families, Texas Right to Life has witnessed firsthand how such policies were abused, thereby jeopardizing patients’ lives.  In many cases, health care personnel placed a DNR in a patient’s medical file without knowledge or consent of the patient or surrogate, even when placing a DNR directly contradicted the patient’s wishes or written directive.  A new Texas law ensures that most patients will no longer suffer this injustice.

The Patient Consent for Do-Not-Resuscitate Orders reform bill, spearheaded by Representative Greg Bonnen, M.D., (R – Friendswood) and state Senator Charles Perry (R -Lubbock), takes effect this weekend, ending a dangerous and anti-Life practice of secret or unwanted DNRs being issued for vulnerable Texas patients.  The personal stories of Texans affected by anti-Life hospital policies were a driving force throughout the protracted months of crafting legislation to restore this civil liberty.  During testimony on the bill last year, Georgetown resident and nurse Carol Williams shared her saga of fighting against a secret DNR written on her husband, illustrating the tragedy that occurs when a patient’s wishes are overridden by a secret and unwanted DNR.

Carol spoke just 34 days after her husband, Bryon Williams, 40, passed away.  He was subject to a secret DNR at St. David’s Georgetown Hospital.  Bryon and Carol submitted his advance directive, indicating that in the event of an emergency, he wanted full code status and full treatment.  Although his care providers knew about his advance directive and his wishes were clearly communicated, Bryon was coded with DNR status, meaning that in the event of an emergency, he would not be given resuscitative measures or helped to breathe.

Carol expressed her shock, “She [the nurse]pointed to a purple wristband and asked if I knew what it meant.  She told me, ‘It means he is DNR.’”  The nurses and therapist “were confused because the code status as DNR in the computer conflicted with my husband’s advance directive for full code.”  Despite Bryon’s clearly defined wishes in his advance directive and the stated wishes of his wife, the hospital decided that he would not receive the medical attention he requested.  Even after Carol learned about the DNR from the nurse, her husband’s status was not changed.

The results of this secret and unwanted DNR were tragic.  Carol continued:

On the night he had a respiratory arrest and subsequently a cardiac arrest, the respiratory therapist responded immediately, but the nurses did not.  They stood around and refused to call a code. When someone finally did, it was immediately cancelled.  I verbally repeated that any DNR was revoked.  The emergency room doctor showed up, intubated my husband, and when he requested chest compressions be started, the nurses refused.  Instead, they called the doctor who had written the DNR asking him what they should do.  They were instructed to support his respirations, but absolutely do not do chest compressions. 

Only after Carol threatened to take legal action, the nurses began CPR on Bryon.  By then, the resuscitation attempts were too late.

After this experience, Carol became an outspoken advocate for the DNR Consent bill.  Carol pledged, “I am now committed to ensuring that no other patients or families will ever be subjected to an unauthorized DNR against the clear advance directives of patients and their families and that any revocation of DNR be honored throughout any Texas hospital.”

The dedication of Carol and other Texas families who shared similar accounts of being victimized and bullied by hospitals inspired Pro-Life champions in the Texas House and Texas Senate to pass the DNR Consent bill.  Governor Abbott personally intervened to clear obstacles to the passage of the bill and enthusiastically signed the bill into law last summer.  The DNR Consent bill, Senate Bill 11 from the First Called Special Session of the 85th Texas Legislature, takes effect on Sunday, April 1, 2018.

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