Vol. 7, No. 5, Pg. 21. Do Not Resuscitate Orders and Emergency Medical Services.

• Author: By Stephen P. Williams, Susan A. Lake and William A. Prince

South Carolina Lawyer

1996.

Vol. 7, No. 5, Pg. 21.

Do Not Resuscitate Orders and Emergency Medical Services

21Do Not Resuscitate Orders and Emergency Medical ServicesBy Stephen P. Williams, Susan A. Lake and William A. PrinceIn recent years, the South Carolina General Assembly has provided progressive mechanisms for South Carolinians to state their wishes about end-of-life decisions through the Death With Dignity Act and the Health Care Power of Attorney Act.

22Even with these types of advance directives, citizens with terminal illnesses continued to face problems regarding their wishes not to receive resuscitative treatment from emergency medical personnel. Because of their statutory and regulatory duties, emergency medical services (EMS) workers could not legally follow these directives and were required to always provide resuscitative measures, in contravention of the patient's advance directives.

When terminally ill patients began to die at home from their illness and panicking family members called 911, these patients were often resuscitated with emergency life support treatment. Sometimes they were delivered to the hospital emergency room with significant irreversible brain damage caused by lack of oxygen prior to and during the resuscitative process, extending their lives in a manner the patient had specifically sought to avoid.

In 1994, the South Carolina General Assembly responded to this problem with passage of the Emergency Medical Services Do Not Resuscitate (DNR) Order Act. S.C. Code Ann. § 44-78-10 et. seq. (Cum. Supp. 1995). Regulations detailing procedures for EMS workers to follow in carrying out the purposes of the Act were approved by the General Assembly in 1995. (See DHEC Regulation R 61-7, § 1200 et. seq.)

The EMS-DNR order works very differently from a Living Will or Health Care Power of Attorney, which are available from a wide range of sources and are completed by the patient. Further, the patient can be in perfectly good health and complete one of those documents.

In contrast, the EMS-DNR Order can only be issued by a physician to a patient who requests the order and who has a terminal condition as defined in the Act. That is, the patient must have an incurable or irreversible condition that within reasonable medical judgment could cause death within a reasonably short period of time if...