Clinical Ethicist Reacts to House M.D. DNR Episode 

Lord help us!

Probably the very most unethical, other than evil scientists. But the writers would give him the win all the time, of course.

It's definitely another layer!

Thanks! I'll check it out.

Thanks! Will do!

It's extremely unlikely that this would happen in a hospital. The procedure is to call a code blue, at which point physicians and nurses from the unit would come to the room. They would all know that the patient is DNR. Some hospitals have other signs for staff, like a different coloured bracelet or a sign on the wall. It's possible that a patient could be wandering around the hospital and collapse, so someone nearby begins resuscitation without realizing the patient is DNR. My guess about the law in most places is that beginning resuscitation if you don't know the patient is DNR is legally fine (not legal advice though!). Mistakes are more common on long-term care homes and prisons. Here's a story about staff at a care home failing to resuscitate a resident because they thought she was DNR (it was actually her roommate). The family has sued: www.courant.com/2024/03/27/a-ct-woman-died-in-a-care-center-her-family-says-it-was-due-to-error-in-do-not-resuscitate-order/

@ValueJudgments thank you for that amazingly detailed explanation. I worked as a security guard in a hospital for 6 years and was always fascinated by the medical field. But unfortunately, most of my questions like this weren't taken seriously when I asked them. I often was given "that couldn't happen" or "that's a stupid question" with no explanation. So again, thank you for the detailed response explanation and article for reference.

@@smithysforge5309 That's a tough job. You're a legend for doing that work. I bet you have a lot of stories! I just found this case of basically what you were asking about. A nurse found a patient unresponsive, the code blue team arrived, there was confusion about his code status, so they began resuscitation and he was resuscitated before they confirmed he was DNR. He won $400,000 in a lawsuit. www.physiciansweekly.com/jury-awards-400000-in-wrongful-prolongation-of-life-lawsuit/#:~:text=The%20estate%20of%20Rodney%20Knoepfle,DNI%5D%20during%20a%202016%20hospitalization.

@ValueJudgments haha well thank you for saying that, and you're right. I've got quite a few stories, some good, some bad, some head scratchers and some that I still laugh about to this day. This article is a very interesting read. I can honestly say I've always struggled with the concept of lawsuits against doctors or hospitals in these types of situations. Seems there's there's both a fine and hard line when it comes to this. For example, if a guy is driving and gets into a horrible wreck and the EMS crew that shows up just reacts and resuscitated him. But he had a DNR then they could potentially be in danger of a lawsuit. Unfortunately, the legal field of medicine seems to be quite the mine field

Ethically speaking, sure. Suppose at this point in the episode that the doctors knew for sure that Giles didn't have ALS and that the new treatment was simple, but they accidentally gave him medication that stopped his heart. If fGiles said that he was only requesting the DNR based on his belief that he was likely to die soon, and this turns out to be false, resuscitation could be justified. But House has nothing like that kind of evidence when he resuscitates him. A DNR order is a medical order made by the healthcare provider in charge, but patients can refuse interventions for whatever reason they want. The bar for valid refusal is lower than the bar for informed consent, so Giles could say, "I don't even want to go to the hospital", which is his right. His decision might be uninformed or unjustified, but that wouldn't give doctors the right to treat him against his will. I'm not sure what a lawyer would say about this kind of case. Maybe I can talk LegalEagle into a collaboration one day!

Shoot! You're right. House trivia fail on my part. Assisted dying is legal in New Jersey, but it requires being likely to die within six months, so John Henry Giles still wouldn't qualify.

Ughhhh.

Same here cos he’s the best.

Thanks for watching!

Sure! Thanks for letting me know!

Thanks!

I've had a couple cases like this. I'll make a video about it. Stay tuned!

Thanks. I have a correction in the description.

All my points about what he should or shouldn't do are about ethics. Since the law and ethics overlap for DNRs, I include the legal points at no extra charge. Clinical ethicists tell people what the law says in cases where it's clear-cut, but you're right that the law and ethics sometimes come apart. In those cases, I'm clear that my recommendation differs from the law, so they should consult a lawyer and they have to decide what they want to prioritize. Cases like this are pretty rare, but it's somewhat more common for the law to be silent or ambiguous on an issue.

@@ValueJudgmentsheavy semantic use to avoid the reality. The same concept would fall under the good samaritan act in the case of a attempted suicide. Same moral dillema, but the legal red tape is on your side as opposed to against you. Don’t say they overlap when there are clear lines drawn

Is that why House won't return my requests for comment!?

@@ValueJudgments, oh, I get it… …you think a lot of viewers think it’s real.

@@JimCGamesit’s more of a analysis of fiction, ya know, a human past time since we first started telling stories. That being said, this man isn’t ethical, he’s just really good at following the legal guidelines. Ethics aren’t the same as laws.

@@milewesler9592, “…analysis of fiction…”? Is it? When you say this and that isn’t so? You’re imposing reality onto “fiction”. fiction /fĭk′shən/ noun The category of literature, drama, film, or other creative work whose content is imagined and is not necessarily based on fact. I watch programs all the time and see things that don’t coincide with reality, except when they want it to. For instance, all the millions and millions of retail outlets with cameras and yet crimes go on in these areas and police never have the inclination to look for such videos. Even when they occur inside these establishments, it’s the same thing. Or how about when on NCIS they storm into a building without first obtaining a warrant. They knew where they were going ahead of time, and yet they never sought a warrant. They come upon their destination, immediately arm themselves and start maneuvering around the building ready to rush inside and take down the villain. Yeah, we’re so set on all the details of fiction and these programs persist and nobody bats an eye. Why? Because it’s fiction!

@@milewesler9592, it’s an author’s work. If these people are so set on inserting every nuance of reality into fiction, I think they should go write their own screenplays. Fiction doesn’t always work if you go to that extreme because the author is trying to bring about specific scenarios to further the drama within it that can’t otherwise evolve upon such insistence.

It certainly makes for better television.

People like people who can see past rules and red tape and do the right thing regardless