FOCUS - 14 of 26 DOCUMENTS
Copyright (c) 2002 Cleveland State University
Journal of Law and Health
2002 / 2003
NOTE: Do Not Resuscitate Decision-Making: Ohio's do not Resuscitate Law Should be Amended to Include a Mature
Right to Initiate a DNR Order
"Constitutional rights do not mature and come into being magically only when one attains the state-defined age of majority.
as well as adults, are protected by the Constitu-
tion and possess Constitutional rights."
Consider the following scenario in light of the ethical and the legal implications that would arise:
A cystic fibrosis patient, nearly 18 years old and unmarried, is brought to the ER in respiratory distress. She's told the ER nurses and the attending doctor that she wants a Do Not Re-
suscitate (DNR) order, but her parents are refusing to sign it. Meanwhile, the patient goes into respiratory arrest. What would you do?
This scenario was printed in a 1993 edition of the nursing magazine,
along with the responses provided from various nursing professionals. In reply, the majority of nurses expressed that any solution
would be problematic based on the ethical and legal issues involved.
For instance, a Tennessee home health nurse wrote "I would have to assist in the code [to resuscitate], even though it would break my
and a Pennsylvania rehab nurse commented "I would like to honor the patient's wishes, but I have no legal basis for doing so."
The moderator, Amy Haddad, a physician and widely publicized
ethicist, noted that although parents have the legal right to make medical decisions for their
have rights as well.
Even if there are ethical reasons for not issuing or implementing a
DNR, we must remember that parents do not always do what is best for their children, and it is possible that there are other factors that must be taken into consideration.
As reflected by the scenario, as well as the nurses' responses, matters involving a
capacity to make health care decisions are highly debated. Changes in both the common law and legislation
over the years have resulted in
gaining some degree of autonomy in making their own medical decisions.
According to Professor Angela Holder, "the court and legislatures of this country have
not been unmindful of [these] societal changes, and there is a definite trend toward allowing adolescents more freedom to make decisions, and to exercise autonomy and self-determination in
relationships with healthcare providers."
Even though these decisions typically involve low-risk medical procedures, as opposed to
-sustaining treatment, some states permit
make significant medical decisions, including whether to have an abortion without parental consent or notice.