Article on Wrongful Prolongation of Life – A Cause of Action That May Have Finally Moved Into the Mainstream
An elderly gentleman with multiple health problems was resuscitated following a near-death experience and vowed not to let it happen again. In an effort to signal his desire to prevent a repeat of such heroic efforts, he executed a do not resuscitate (“DNR”) directive following his recovery. A short time later, he developed severe discomfort and was taken to a local emergency room where he was diagnosed with a ruptured aortic aneurysm. None of the medical staff bothered to read his DNR directive, resulting in the elderly man undergoing a potentially unwanted surgery to repair the life-threatening anomaly.
A physician subsequently discovered the DNR directive and discussed the issue with the patient. The man angrily reconfirmed his wish to shun resuscitation efforts and, in response, the physician placed a DNR order in the chart. The surgeon who had performed the complicated operation became furious when he saw the order and changed it back to a “full code,” a directive to employ all life-saving measures. This reversal triggered a consultation with the hospital’s ethicist, which ultimately resulted in the reinstatement of the patient’s DNR order. The elderly man eventually died from a heart attack during his hospital stay, seemingly without any further intervention.
Historically, physicians were able to act with impunity concerning end-of-life decisions because the courts did not recognize an action for wrongful prolongation of life. Many in the medical community believed that if “you do intervene and you shouldn’t have, the worst that will happen is that the patient will live a little longer and that you’ll never be held accountable if you keep the patient from dying.” This attitude is undergoing a metamorphous as an increasing number of patients who have signed DNR orders are suing or subjecting medical providers to disciplinary proceedings for saving their lives. This article will provide a historical background on DNR orders and the various legislative initiatives undertaken to ensure that medical providers honor a person’s end-of-life wishes. It will then explore the evolution of the wrongful prolongation of life litigation in a chronological fashion, with a focus on the majority of cases that do not allow recovery and the more recent determinations that have offered patients relief for the failure to honor their end-of-life directives.