Man just wants to be left for dead

An 83-year-old man fears if he collapses in public he will be resuscitated and doomed to spend the rest of his life as a vegetable.

Ken Keall, of Palmerston North, is one of thousands of New Zealanders who have requested ‘‘do not resuscitate’’ orders, according to Medic Alert.

However, Keall still worries that a lack of public knowledge on the subject will see him resuscitated by an unwitting good samaritan.

Keall has lung capacity of 26 per cent, bladder cancer, heart trouble and cancer in one lung. ‘‘The doctor said to me, with your state of health, if anyone administers CPR you could end up in a wheelchair or could end up as a vegetable. I certainly do not want CPR. [My lung capacity] is irreversible and it will get worse. Eventually, it will probably kill me.’’

Keall says he has faced a battle to get his wish officially accepted by Palmerston North Hospital, but finally got some respite in the form of an official Medic Alert tag. Hospital policy is for a form to be filled out every time a patient visits. Keall said a piece of paper might not be seen by someone performing CPR, so he always wear his tag around his neck.

However, Keall still worries that if he collapses in public, he will be resuscitated. ‘‘If I collapse in the street, in The Plaza, most of the public would still administer CPR. They just don’t know. The general public have not got a clue. CPR is a wonderful thing. The people who administer it are caring people, but there are exceptions to it.’’

Midcentral DHB chief medical officer Kenneth Clark said bracelets and tags were helpful, but had to be easy to see. ‘‘In the end, they have to be seen in an emergency situation. They have to be read in an emergency situation. The patients are free to have those and generally they are well regarded.’’ However, it was not always clear what a patient’s wishes were. ‘‘If a patient arrives and requires resuscitation and we’ve got no background, no forms, no information, then we resuscitate. We don’t know what the views of that patient will be. We have to assume because you only get one chance.’’

Patients could fill out a form at the hospital to say they did not want to be resuscitated, but this had to be done each time they were admitted in case they changed their mind. Patients had to be ‘‘competent’’ to sign the request, he said.

Medic Alert Foundation business development manager Richard Cooper said it was a growing issue. Thousands of New Zealanders were in a similar position to Keall, but there was the potential for that to be tens of thousands.

‘‘These patients are not just case studies, their stories and requests do not come from a place of wanting to die, they come from a place of wanting to choose their dignified release when they know that being resuscitated will cause them undue harm.’’

Cooper said there needed to be more debate on the issue. ‘‘And not just in closed-door sessions with select groups of health professionals to argue the quandary of opening pandora’s box of ethical [and] legal debate, but honest personal experience from the public and government policy makers and politicians actively forced to listen to the people’s voices.’’

St John medical director Dr Tony Smith said both it and Wellington Free Ambulance had a consistent approach to advance directives and advance care plans.