Dutch doctors call on elderly, ill people to think about DNR orders

Doctors, the Dutch Patient Federation and elderly union ANBO are calling on people, especially older people, to think about whether or not they want to be resuscitated. Many people don't think about this, resulting in patients having to suddenly make a decision during an emergency situation or prior to a risky medial procedure, they said to AD.

Dieredik van Dijk, professor of intensive care at UMC Utrecht, spoke to a number of resuscitated patients who later decided it was not what they wanted. Due to the stress or time pressure in the moment, patients often can't make an informed decision, he said to the newspaper. It is therefore necessary to talk and think about resuscitation before you are in an emergency situation, Van Dijk, the Patient Federation and ANBO said. This is especially true for people who are at a higher risk of dying due to their age or health issues. People can discuss a Do Not Resuscitate order with their house doctor, or at a clinic. 

"In principle this call is for everyone, because it can happen to anyone that you suddenly end up in an emergency room", Liane den Haan, director of ANBO, said to NOS. "But it naturally involves mainly elderly and vulnerable people, or already ill. It is very important that they think about this." Older people have to decide what they want, Den Haan said. "Otherwise their families have to do it. That is difficult if it was never discussed."

"It is time for an awareness campaign", Thom Meens of the Dutch Patient Federation said to AD. According to him, people prefer not to think about the last phase of their lives. "If you are in the emergency room, you are actually already too late. Because the conversation is so difficult, you have to have it with a trusted counselor: your GP, because he also knows your home situation." ​Meens also said that this call is mainly for the elderly. "Think about it when you notice that you are deteriorating. For most people, this is roughly between 70 and 80 years. The moment you think about things like 'who should handle my finances if I can not do it anymore?', then it is also time to think about resuscitation at the end of life."

The Patient Federation teamed up with a number of GPs to publish an information leaflet about DNRs. This will eventually be available through all GPs. Though the national family practice association LHV could not tell AD whether all GPs are actively talking to patients about resuscitation. "We do not have figures, but more and more GPs are conducting these conversations. This is also a logical consequence of the growing group of elderly patients in general practice", a spokesperson said to the newspaper. 

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