CPR, DNR, and Letting Go
It is a very emotionally difficult position to be in when a physician asks the family if they want them to do all they can to keep your loved one alive or if you want them to pass away naturally.
That conversation, if unprepared for, is very hard to navigate because no one wants to feel like they are choosing to end a loved one’s life. At least that is how the choice can seem.
So here I want to give you some considerations about this end-of-life decision that may be presented to you by a physician.
Let me first deal with what a physician means by “doing all they can to keep them alive.” Keeping them alive means giving CPR or medication to adjust blood pressure or putting in a breathing tube or making use of drugs to induce what is sometimes called a medical coma.
If a patient’s heart stops and there is no Do Not Resuscitate order then the medical team will automatically proceed with those measures. A Do Not Resuscitate, commonly called a DNR, is a signed statement by family that they or the patient does not want heroic measures or machines to keep them alive.
What a DNR means is that there should be no CPR administered if the patient’s heart stops. This is a difficult decision for the family to make but know that it does not mean anyone is giving up on the patient. No patient dies because of a DNR, they die because they have heart disease or cancer or trauma injury or whatever condition it was that brought them to this point.
CPR cannot restore one to health or wellness. It merely resuscitates the heart. The best practice for CPR’s use is on a healthy person who had an accident or heart attack with no other underlying life threatening conditions.
There are some downsides to administering CPR because a patient can be left in a worse condition afterwards. CPR, when done correctly, can leave ribs broken, lungs punctured, spleen busted, and brain damaged to the point of a permanent vegetative state.
At some point, a patient’s medical care focus may shift from cure to comfort. Only the physician and nursing staff can determine if the path to cure has been exhausted. When that point comes, the medical focus shifts to comfort care.
It is important and necessary for the family of the patient to shift in their focus as well. This is a stage of letting go and letting God.
I have seen too many families push for full attempts of CPR, but not for the patient’s benefit, but for their own. Telling the physician and staff to do all they can sometimes is an attempt to hide the regrets this struggle is reminding them.
As painful as it is to watch a loved one go, please know that you are not giving up. You are letting go because you are trusting in God’s will. Sometimes we have to consider that their ultimate healing is in eternity and we will be with them again there.
Letting go is letting God lead as the medical team shifts to comfort care. Comfort care gives attention to the dignity of the patient, caring for their pain management, and allows for family to say their goodbyes.
When the family is willing to let go, they are willing to trust God for the outcome of their loved one and their own future without them.
Death is a sad reminder that we live in a sinful fallen world, broken by the devil’s effort to malign the character of God.
Letting go is relying on the promises of God that says, “Do not fear, for I am with you” (Isaiah 41:10) and “I will fear no evil, for you are with me” (Psalm 23:4) and “surely I am with you always” (Matthew 28:20).
There is a verse in Psalms 116:15 that says, “Precious in the sight of the Lord is the death of his faithful servants” (NIV). What this verse is telling us is not that God takes pleasure in death, but that He takes pleasure in our transitioning from our mortal life into our immortal life with Him in Heaven.