News Briefs
Wisconsin adopts a new medical "do-not-resuscitate" law
By Barry W. Szymanski
A person now can request a "do-not-resuscitate" bracelet from his or
her physician, and responding emergency medical personnel will not
perform CPR.
Under the new law, which became effective Jan. 18, 1997, a person
requesting the do-not-resuscitate (DNR) bracelet must be at least 18, not pregnant, and have a
terminal condition, a medical condition such that resuscitation would be
unsuccessful or cause significant physical pain or harm outweighing the
possibility of successful resuscitation.
An attending physician may issue a DNR order only if the patient
requests and signs the order. This physician places the bracelet onto
the patient's wrist and documents the patient's medical record.
The DNR bracelet is a clear, standard hospital-type bracelet at least
3/4 of an inch wide with the words "Do Not Resuscitate" and the State of
Wisconsin seal printed in blue. The physician issuing the DNR order
prints on the bracelet insert form the patient's name, address, date of
birth and gender, and the physician's name, business phone number and
original signature.
The do-not-resuscitate bracelet directs emergency medical
technicians, first responders and emergency health-care facilities
personnel not to attempt cardiopulmonary resuscitation on the person
wearing the bracelet.
By law, "resuscitation" means cardiopulmonary resuscitation,
including cardiac compression, endotracheal intubation and other
advanced airway management, artificial ventilation, defibrillation, or
administration of cardiac resuscitation medications. However, emergency
medical technicians and emergency health-care facilities personnel shall
perform the Heimlich maneuver to expel an obstruction from a person's
throat
What happens in an emergency?
Emergency health-care personnel must first assess the patient. If the
patient is pulseless and nonbreathing, they check the patient's wrist
for a DNR bracelet. If there is no bracelet on the patient's wrist, they
provide the usual EMS care. If a DNR bracelet is found on the patient's
wrist and the bracelet is not defaced, they will not undertake life
support measures; however, they shall provide comfort care. Examples of
comfort care include administration of oxygen, clearing the airway,
controlling bleeding, positioning for comfort, providing emotional
support, pain medication and splinting.
The DNR order shall not be followed if the patient has revoked the
order, the do-not-resuscitate bracelet appears to have been tampered
with or removed, or the responders know that the patient is
pregnant.
How do you revoke a DNR order?
A patient may revoke a DNR order at any time by: a) expressing his or
her desire to be resuscitated; or b) defacing, burning, cutting or
removing the bracelet. If the patient tells the EMT, first responder or
the emergency health-care facility personnel that they are revoking the
DNR order, then the EMTs are to promptly remove the bracelet. The EMTs
shall notify the attending physician of the revocation, and the
attending physician shall record the revocation in the patient's medical
record.
A request to resuscitate by the patient's family or a friend does not
supersede the DNR order if the patient is wearing a valid bracelet and
has not revoked the order.
What about liability?
No physician, EMT, first responder, health-care professional or
emergency health-care facility may be held criminally or civilly liable,
or charged with unprofessional conduct, if they withhold or withdraw
resuscitation from a patient with a DNR order.
Any person who willfully conceals, defaces or damages the DNR
bracelet without the wearer's consent may be fined not more than $500 or
imprisoned for not more than 30 days or both. Any person who falsifies
or transfers a DNR bracelet or conceals the revocation of a DNR order
shall be fined not more than $10,000 or imprisoned for not more than 10
years or both. If a person coerces, threatens or intimidates an
individual, causing that individual to sign a DNR order, that person
shall be fined not more than $500 or imprisoned for not more than 30
days or both.
For further information about this new law, review Chapter 154 of the
Wisconsin Statutes as amended by 1995 Wisconsin acts 168 and 200, and as
ruled upon in the Wisconsin Administrative Code HFS Chapter 125.
Wauwatosa attorney Barry W.
Szymanski 's practice includes estate planning and emergency
medical law.
He also serves as attorney for the Wisconsin Emergency Medical
Services Association and is a certified police officer.
State Bar seeks ABA delegate candidates
The State Bar of Wisconsin seeks candidates interested in serving as
State Bar representatives to the American Bar Association (ABA) House of
Delegates.
The ABA House of Delegates' responsibilities include:
- establishing association policy and defining the ABA's positions on
professional and public issues;
- electing the ABA's officers and board of governors after receiving
nominations from the ABA's Nominating Committee;
- amending the ABA's Constitution (jointly with the ABA Assembly of
Members);
- creating or disbanding association committees and sections; and
- setting membership dues (after conferring with the ABA's Board of
Governors).
During their two-year term, State Bar of Wisconsin delegates are
responsible for attending each House meeting, participating fully in its
proceedings and discharging the House's responsibilities. The delegates
also keep their constituency fully apprised of House actions and, to the
extent possible, of matters pending before the House. They also assist
constituent entities in presenting issues of concern for debate and
action by the House.
An election of two State Bar of Wisconsin members, or in odd-numbered
years one member and one member of the Young Lawyers Division, to the
ABA House of Delegates will be held at the June 24, 1997, Board of
Governors meeting during the Bar's annual convention.
Members interested in representing the Bar in this capacity should
review Article III, Section 11, of the State Bar of Wisconsin bylaws for
qualifications for election and election procedure.
Wisconsin
Lawyer