DNR Followup

Just to recap, earlier this year I had a patient in a lethal heart rhythm who had a DNR. He was completely aware of himself and his surroundings, and verbally reaffirmed what his paperwork said - that he wanted to be allowed to die peacefully. I ran into one of the nurses from that day, and asked her if she remembered him. I was curious to know what became of him. The hospital opted not to honor his DNR, and had begun aggressive treatment by the time I left the ER to go on my next call.

Turns out the ER docs continued to treat him as if he were a full code, until they finally got in touch with his personal physician. His doctor assumed care, and discontinued treatment with the exception of (gasp!) palliative care, as the man had wished (and documented in his DNR/advanced directives). He was admitted to the hospital with a heart rate in the 20s, said goodbye to his family, and died a few hours later.

The nurse told me this story with a tone I can only describe as "pitying". As in "What a shame he died". I wonder what happened to "What a joy he isn't suffering any more"?

I don't really have a clever comment to add. I'm just sad the hospital didn't honor his wishes.