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OPINION | MASTERSON ONLINE: Reconsidering DNR

by Mike Masterson | September 25, 2021 at 3:53 a.m.

At this stage of life, I've considered signing a Do Not Resuscitate (DNR) order should doctors believe I'm at the end with no hope of restoring quality of life (well, except to wonder if the care home is serving Salisbury steak or spaghetti for dinner.)

Then I read something interesting. Before deciding to sign a DNR, valued readers would be wise to examine an e7health.com analysis of 10 peer-reviewed studies from, among others, the American Heart Association, Harvard University and the Centers for Disease Control.

The analysis doesn't advise against signing such an order, but concludes that patients and their families should consider their individual circumstances.

The orders intended to reduce needless suffering often can lead to increased death rates and worse care, according to e7health. Jonathan Baktari, the triple-board-certified CEO of e7health, explained potential problems with signing a DNR without becoming familiar with what it actually entails.

Key findings included that DNR orders "doubled the death rate for surgical patients despite fewer complications: A Harvard Medical School study found 13 percent of patients with DNR orders died after surgery compared to 6 percent [without], despite having lower rates of post-operative complications, including pneumonia, surgical-site infection and kidney failure," according to a press release from e7health.

I know how that sounds, yet twice as many deaths among DNR patients sure catches my attention.

Another finding was that "patients received less care not related to heroic measures or resuscitation: DNR geriatric patients were 7 percentage points less likely to have blood cultures drawn, 12 percentage points less likely to have a central IV line placed, and 12 percentage points less likely to receive a blood transfusion."

Finally, signing a DNR early in a health crisis can be deadly, as evidenced by cardiac arrest patients (who signed one within 24 hours, before a prognosis could be made) surviving just 5.2 percent of the time compared to 21.6 percent survival for non-DNR patients.

Thought you should know.

Endless pleas for cash

It's indeed a sad state of affairs when the endless stream of daily messages that pop up in my email are often from politicians pleading for donations. The requests are relentless, some designed to make me feel guilty if I don't fork over donations.

This is the perverted mercenary climate we've created and allowed to flourish across the nation's political spectrum. How are average citizens caught in an inflationary cycle supposed to afford political contributions toward any candidate's purportedly desperate political needs, and stay afloat?

How shameful to have established a nation where outcomes of our elections supposedly rest on a send-me-more-and-more-money system.

What an out-of-whack process when election results aren't dictated by a candidate's abilities, ideas and policies, but rather by the size of the financial war chest they can accumulate.

Sounds to me increasingly like a Third World corrupt system of politics and government than the America in which we of the baby boomer generation were raised. We all know well what the Good Book has to say about the love of money and how it translates to evil.

First FOIA symposium

The statewide umbrella group devoted to ensuring transparency in government is set to hold its first annual symposium Sept. 30 at the North Little Rock Riverfront Wyndham Hotel. It will focus on the many public benefits of our Freedom of Information Act.

I say it's an event folks would find well worth attending if possible.

The public is invited to attend the day-long conference sponsored by the Arkansas Transparency in Government Group (ArkTIGG) that will feature speakers on the need to spread disinfecting sunshine within the halls and records of those elected and appointed to lead.

Count me among those pleased that ArkTIGG chapters, each laser-focused on effectively utilizing our Freedom of Information Act, continue to spread through Arkansas communities to include groups in Hot Springs, Conway, Harrison, Bella Vista and Fort Smith.

Hopefully, one day, the majority of Arkansas' cities and counties will have a TIGG chapter.

Arkansans who are influential in transparency and TIGG's mission will be speaking on Thursday. They include UALR Law Professor Rob Steinbuch, Fort Smith attorney Joey "Bulldog" McCutchen, Bella Vista transparency activist Jim Parsons, and FOIA advocate Dr. Bill Ray Smith from Harrison.

Also among speakers are Beth Walker and Ray Pierce with the state's attorney general's office, state Sen. Dan Sullivan of Jonesboro, 12th Judicial District Prosecutor Daniel Shue, and members of the FOIA Coalition and FOIA Task Force.

Professor Steinbuch's program: "The FOIA today" will be eligible for valid participants to receive continuing education credits. Sessions begin at 9 a.m. with an hour break for lunch, and run until 5:30 p.m. with breaks strategically scattered throughout the day. The symposium also can be accessed on ArkTIGG.com and ArkTIGG's YouTube channel.

The only thing to add is to emphasize--as if I'm not already a broken record on the subject of FOIA--how critical the law is to ensuring our citizens remain aware of the effectiveness of our state and local governments and their bureaucracies in serving their interests.

It's also only wise for Arkansans to learn about the important law to better understand how effectively or ineffectively local prosecutors are performing their responsibilities at enforcing the 1967 law in Arkansas communities where friendships and associations often unfortunately can play a role in that happening.

Now go out into the world and treat everyone you meet exactly like you want them to treat you.

Mike Masterson is a longtime Arkansas journalist, was editor of three Arkansas dailies and headed the master's journalism program at Ohio State University. Email him at mmasterson@arkansasonline.com.

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