The Tragedy: Thou Shall Not Kill
Doctor DNR Notes with Footnotes
Transcribed from Dr. Shokar’s October 13 (the day Grace died) hospital report (summary of 8:00 a.m. phone call that morning):
"I had a discussion with the family over the phone for roughly half an hour to an hour in regards to code status once again as well as feeding options they have.
They had deliberated yesterday after our conversation and decided for a DNI status.
We did discuss in regards to CPR resuscitation and the futility of doing CPR
in the situation to DNI and they agreed in regards to not pursuing a resuscitation
via CPR or defibrillation in the event of respiratory arrest leading to a cardiac arrest.
In all regard, they want to continue full management without intubation.
We will continue and wish to continue with BiPAP therapy as long as possible.
If there is a deterioration and hypoxia
without reversibility for prolonged amount of time,
we may consider at that time switching to comfort care
after a discussion has been completed with family to see if that is the right time. In the meantime
and hopefully, we will continue care with the goal of improvement."
Note: bold and underline added for emphasis.
See footnotes at bottom of page.
- At no time did we ask for Grace to be labeled DNR. We also did not agree to DNR status at any time. The hospital’s letter to us, explaining her DNR status, references the doctor note, above, as the reason Grace was labeled DNR.
- We never signed any statement regarding Grace being DNR, as required by law.
- On Grace’s last morning, the doctor encouraged us to approve a feeding tube because Grace was improving – why would anyone be considering DNR when she was doing so well?
- Grace was not wearing a DNR bracelet, as required by law.
- The first time we knew Grace was labeled DNR was when we were screaming for the nurses to do something and reverse the morphine given to Grace. Their response, "She’s DNR" was their excuse for not helping her. We screamed back, "She’s not DNR" and they did nothing. They stood outside her door instead. Jessica later told us an armed guard was also outside the room.
- Per Jessica’s (Grace’s sister, her advocate in the room when Grace died) summary of events: "One nurse read off what the computer stated and that the doctor labeled her as a DNR which they claimed they couldn’t do anything about."
 This term was not discussed, and we now know it meant labeling Grace DNR – Do Not Resuscitate
 Discussion was in regard to the fifth incident of asking us for ventilator permission
 Do Not Intubate – i.e. ventilator
 This was all hypothetical, in that Grace had good days on October 12 and 13, according to our calls with Dr. X and our bedside experience.