Do-not-resuscitate orders focus of proposed Mo. bill

Bruns confident of passage
Sunday, January 28, 2007 | 12:00 a.m. CST; updated 12:02 p.m. CDT, Tuesday, July 22, 2008

JEFFERSON CITY — A bill to allow emergency responders to comply with do-not-resuscitate orders has been filed by a retired firefighter.

Rep. Mark Bruns, R-Jefferson City, said he has sponsored the proposal the last two years because of his experiences responding to emergency situations when do-not-resuscitate orders were in place.

“We had no way of knowing there was a medical history and would start resuscitation,” he said, adding that the procedures can be difficult for family members to witness.

Dean Martin, division chief of the Columbia Fire Department, said he thinks the bill is a good idea.

“It’s been an issue for responders,” Martin said. “They arrive on a scene because they’re at home for hospice care and there is no documentation and the family is saying they are DNR,” he said.

Without the documentation, emergency responders are required to initiate care until the documentation is provided, Martin said.

“Ultimately, I think this is designed to make a stressful situation a little less stressful,” he said. “The family’s wish is the most important thing to make sure is being honored.”

Last year, Bruns sponsored a much broader bill to establish a statewide regulated system for do-not-resuscitate orders. The measure didn’t receive a committee hearing.

Bruns said the concerns voiced last year about his broader bill were legitimate and that he spent the summer working with lawmakers to address them.

The new bill is limited to emergency workers such as emergency medical technicians and firefighters. Also, this year’s bill has a provision stating that it “shall not authorize, or approve mercy killing or euthanasia, or to permit any affirmative or deliberate act or omission to shorten or end life.” An additional provision states do-not-resuscitate orders are not effective during pregnancy. Bruns said that he is confident that it will pass this year.

Frank Houston, an administrator at Preferred Hospice of Columbia, said that he supports the proposal. He said emergency resuscitation

sometimes can do more harm than good. “Especially if they are elderly because most people in a hospice are elderly and elderly people just can’t take CPR,” he said.

Bruns said he is also concerned that those who choose not to be resuscitated have the opportunity to die in dignity.

“If a person makes a decision in conjunction with their family and physician, we want to make sure that order follows them away from the hospital,” he said.

Rep. Judy Baker, D-Columbia, has co-sponsored the bill. She said that she believes it is the right thing to do.

“I think a patient has a right to decide what interventions are right for their end-of-life situation,” she said.

Baker also said that she has heard from constituents that are emergency workers who were concerned about issues of liability.

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