Vol. 70, No. 3, March
1997
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. |