Is signing a DNR (do not resuscitate) order passive suicide? Yes! 1.

According to the dictionary, suicide means "to intentionally take one's own life." By this definition, as well as by several other related definitions, signing a Do Not Resuscitate (DNR) order is, in fact, suicide. The Christian church will tell you that suicide is an unforgivable sin, and many people and governments adhere to the belief that suicide is always a grave offense. Does anyone want to explore the possibility that there's such a thing as an acceptable suicide? It is my opinion that DNRs are suicide because a person is willingly allowing their body to die. However, it is also my opinion that, in the situations where DNRs are allowed, this form of suicide is not wrong. How can suicide not be wrong? I suppose it all comes down to personal belief about a natural life span and to what extent technology edges into "playing God." By the time someone signs a DNR, there is generally a very definite reason for this. Many times they are people whose bodies are already on the edge of death, right on the brink of failure, and the only thing that has kept them alive in the past has been machines and the unwavering efforts of highly-skilled doctors. In this age of so many possibilities for keeping the body alive, shouldn't people have the right to decide when the disparity between "alive" and "functioning" becomes too much for them to bear? For many, a DNR is much more morally acceptable than euthanasia or other forms of inducing death. This order lets medical personnel know that should this person go into a coma or have a massive heart attack, they don't want those efforts being put out for them, they dont want to be kept from the natural course of events. These people recognize that their bodies have gone as far as they'll go and merely wish to keep living until that last fatal event finally claims their spirit. Every person is entitled to the inalienable rights to life, liberty and the pursuit of happiness. We're taught these basic rights from a very young age and the recitation of them becomes second nature, but what might be the implications of these rights? Doesn't our right to life and the pursuit of happiness also entitle us to decide that we only wish to live out our natural lives, as opposed to technologically-extended ones, and to stop the pain when the latter is no longer possible? I am not condoning traditional suicide or euthanasia, but I do say that allowing the body to die a natural death is not wrong, even if it is still suicide by definition. In the end, it all boils down to our own personal beliefs about where a natural life span ends and what technology does for us. In today's world it's easy, if expensive, to continue fixing people up, filling them with medication and swapping out body parts for an unbelievably long period of time. This can extend a person's life to some degree, and when their body has all but given up they can still be kept alive on life support. However, if the body can no longer keep itself alive, I believe everyone has

the right to fulfill their wishes of turning those machines off and/or foregoing and life-saving operations that might be performed. These can prolong pain, amass astronomical debt for the next generation, and in the end it makes little difference because everyone will eventually die. 2. Most times a DNR includes more than do not resuscitate', rather it most often extends to do not take any extraordinary measures'. This would likely include CPR, breathing machines, blood transfusions, etc. Signing a DNR is passive suicide. When a suicidal person takes an overdose or jumps off a bridge, they personally made the choice to end their lives. Now that same person ends up in the hospital, unconscious, on the verge of dying, yet the doctors are able to save them while taking extraordinary measures. Yes, someone else (the doctor) has made the choice to bring them back. By having a signed DNR in this example, and following its orders, the doctors would be unable to expend the necessary effort to save this person. The doctor's, with their hands tied, would then have passively assisted in the suicide. Now take the cancer patient, who is going to die soon. There are ways to extend this person's life, with radical treatments and having to take extreme measures when the body decides it has had enough. Doctors continue on in their valiant quest to ignore the signs and push forward to keep the patient alive. Is it living if the patient is unable to function on their own, pain kept in check by an intravenous morphine drip at hallucinatory levels, breathing only possible with a tube snaked down their throat, and hooked to a noisy breathing machine? I think not since the patient is kept in a delirious state, not able to talk, or function in any semblance of what the ordinary person would call living'. Without a DNR their quality of life will most likely disintegrate as the doctors do everything in their power to keep them alive'. With a DNR, the patient is saying I want to die sooner than later. This, is passive suicide. While I am not making a judgment on whether it is right or wrong to end one's life before all means have been exhausted, I would like to leave you with one important thought: Which is more important Quality of Life' or Quantity of Life'? If you are inclined to believe that Quality is more important, then a DNR is the passive suicide tool required to ensure your wishes are respected. 3. A DNR is document that allows a patient to make his or her wishes known should she be incapacitated by illness or trauma, and that illness or trauma cannot be resolved. If you do not wish to be kept alive by machines, or be "brought back from the brink of death" only to face an ongoing decline of the physical self, signing a Do Not Resuscitate order allows you to convey those wishes to medical staff and family.

It is a form of passive suicide. Allowing yourself to die when the natural order of things is trying to kill you is a form of suicide. If you choose to go gentle into that good night, then family and medical staff should respect your wishes. If you sign a DNR, you know you are going to die, and soon. You know that there is no cure coming in the next week that will return your body to a healthy state. You know that the disease or trauma that has robbed you of your health will kill you. You are in pain. Every moment is a moment of misery. You are living in a state of decay. When you see the light at the end of the tunnel, you don't want anyone pulling you back. The medical team has tubes and machines and injections and can take all sorts of extraordinary measures to bring you back to your now miserable life. But you have chosen to go. Choosing not to use the wonders of modern medicine to evade death for just a little while longer is passive suicide. Not wishing to be revived, and revived again, and again and again is passive suicide. Should you choose to sign a DNR so you can die without doctors and nurses poking and prodding you or shooting electricity through your body like so many Frankensteins, your wishes should be respected. Passive suicide is a choice. It is a decision. And it only exists because of the alternative. Because modern medicine can keep a body alive even after death, there are those who believe that every measure should be taken to maintain life, that a breathing body is life, that defying death is the purpose of life. It is their choice, then, not to sign a DNR, and to be resuscitated again, and again, and again, and again with doctors and nurses poking and prodding and shooting electricity through their bodies like so many Frankensteins. Eventually, though, death will win. So should you die in spite of all the wonders of modern medicine, you can go to your grave knowing you did not commit passive suicide. You just died. NO! 1. Resuscitation of human life is an event understood by few but judged by many. Some individuals feel that allowing a loved one to sign a "Do Not Resuscitate" order, also known as a DNR, or signing one themselves, is condoning a passive suicide. To truly understand this issue, one must fully understand what resuscitation entails. As a respiratory therapist, I have participated in a large number of these events. When a person is a "full code", or does not have a DNR order, we in the hospital setting do everything in our power as a medical team to save that person's life. When we find that a person is dying or is dangerously close, we activate a code team.

The patient is hooked up to a monitor, which electrically checks the rhythm of the heart, as we check for breathing and a pulse. If the patient is not breathing or is having too much difficultly, a tube is placed in the patient's airway. They are then hooked up to a life support machine called a ventilator that takes over the work of breathing, or we breathe for the patient by hand using a resuscitator bag until a heartbeat is regained. If the heart is not beating, a member of code team begins chest compressions. Chest compressions are nothing like what we all watch on TV-to pump the heart inside the chest, ribs usually have to be broken, and you must compress hard and fast to circulate the blood through the body. In the meantime, drugs are being pushed through IVs (hopefully the patient has one or two IV accesses already, or this makes drug administration difficult) to speed up or slow down the heart as needed. If the ventricles of the heart are not pumping, but instead quivering without pumping blood (known as ventricular fibrillation), the heart is shocked with electricity to hopefully put it back into a regular rhythm. When one chooses to become a DNR, they make the active choice to allow nature to take its course for their body in the event that they are dying or close to death. It can be rescinded at any time; a patient can choose to become a full code at any point. DNR does not equate to a death sentence or even a passive suicide. Regardless of one's beliefs, and regardless of all the drugs and medical technology available, our bodies will eventually stop working, or die. Until then, it is the right of the individual or designated next of kin to choose whether or not resuscitation is an appropriate measure in prolonging life. 2. Is making yourself a DNR passive suicide? Absolutely not! In the United States we offer so many different treatments to different illnesses, that a person has not been allowed to die naturally for a very long time. Even CPR is something that has come about in the last 50 years. It used to be that when a person was dying, we would make them comfortable and let them die. We now have technology that can prolong a person's life for quite a while. We have dialysis for the kidneys, open heart and heart transplants, liver transplants, life support machines and breathing treatments to make sure people live longer. People who are in their eighties, who have previously made themselves a "do not resuscitate" are brought to the hospital and put on life support because they have pneumonia and pneumonia is a reversible illness.

Where is the line drawn? When do we let people die because it is their time to go? People with end stage cancer are brought to the hospital and put on life support because their family is not ready to let them go. These people who will not ever come off of the life support until the family realizes that they are torturing their loved one. We then do a terminal wean and let nature take it's course. I believe that television shows and Doctors are to blame for people being allowed to be placed on life support when there is no hope of healing. If a person has end stage COPD or end stage cancer, are we prolonging their miserable existence by putting them on life support or are we prolonging their death and putting them in more pain. Television shows make it seem that if someone's heart stops and the hospital staff preforms CPR on them, not only are they brought back to life, but all of their other illnesses are cured also. Doctors allow family members to believe that there is hope when there is none. They allow the family to go on and on with treatment and life support even when their loved one's body is in decay. When did we step away from the idea that it is not OK to let someone die? Sometimes, it is time to let a person just go naturally. Birth is a part of life, and death is also a part of life. Making sure that no one does CPR on you, is not suicide, it is dying naturally. There is nothing wrong with allowing that to happen to you or to a loved one. We really have gotten away from allowing a person to "die with dignity". If someone tells their family that they wish to die at home, that is a request that needs to be honored. There are several ways that a person can make sure that their final wishes are honored and carried out. 1. Discuss with your family and loved ones your wishes as far as being put on life support. 2. Appoint a medical power of attorney. Make sure that this is someone who will be able to stand up to pressure if there is a argument amongst the family regarding life support. I have seen estranged family members, who are now suffering from guilt, want their family member kept alive artificially in the hopes that they will regain conscience, and allow for apologies. I have also seen vindictive relatives who want their dying "loved one" to suffer as long as possible. 3. Have a living will. This item is not one that is set in stone. It may or may not be honored depending on how your family reacts to you being ready to die. 4. Make sure that your doctor has copies of your legal papers (power of attorney)and your living will. Also make sure that your have discussed

your wishes with your doctor. Have all of this in place before a health crisis strikes. Allowing yourself to be a DNR is not passive suicide, it is dying naturally.

3. Death is the finale of life. As with any good work of literature the finale should be written in by the writer. A DNR is not a lightly taken document and there are many criteria to utilize this document. It is a patients choice as to whether they want "supreme measures" taken to save their lives. It is also very detailed in the circumstances surrounding the death. Suicide, a word meaning to take ones own life, often referred to as a selfish act of ones own choice to die. Again a choice one should have if that is the way they want their play to end. A DNR is not asking to be killed. It is asking not to be tortured, with extraordinary measures, to prevent the one thing we fear the most...death. Medical illness is costly both monetarily and emotionally. It taxes the individual and their loved ones in many forms. But to be forced to live a life of pain and suffering because family is not ready to deal with the loss or the government deems it illegal is selfish. Selfish in the worst way. Pain is the least of the issues here, with modern drugs, but the emotions that a person feels while lying in a bed waiting to die are agonizing. The thoughts of everything they will not be a part of when they go. Watching the ones around them cry and suffer because of their illness. Why would I want to prolong that suffering for them or myself? I have a DNR. I do not consider it any form of suicide. I consider it a way to save myself and my family from pain that does not have to be suffered, costs that do not have to be incurred, as well as an end to the inevitable and a beginning to life as it is. I survived the first time and it cost a great deal, if I find myself in a spot where I know that survival is not an option I would not want to burden my family with the bills that go along with keeping someone alive for just a few more days and why torture yourself and prolong the pain of loss? Death is a part of life. Choosing how one dies should be a part of that script. Since it is not at least we could give the dying a chance to control the end of their story.