The Case of Jimmy: Out of Hospital DNRs for School-AgedChildren
Adapted from Case Study BY ROBERT L. POTTER
Jimmy is twelve years old, bright, interacts well with teachersand other students, and really likes to go to school. However, hisosteosarcoma has advanced to a terminal stage, and he is nowenrolled in hospice for good palliative care. Because of histerminal condition, Jimmy and his parents have agreed together withthe hospice team that any resuscitation attempt would be unwantedand unwarranted.
An Out of Hospital DNR form has been completed, and James’sdoctor signed it. When Jimmy’s parents presented their request thatCPR be withheld if Jimmy’s death should occur at school, the schoolnurse told them that their wishes could not be met. The schoolboard had specifically rejected a policy that would honor DNRrequests for students during the time they were the responsibilityof the school system. The nurse and the principal reinforced thepolicy and insisted that EMS would be called to the scene and CPRinitiated if Jimmy’s condition became critical.
Jimmy was reluctant to attend school under these circumstances,but was committed to getting back into the classroom without havingto give up his DNR status. His parents enlisted the help of theethics committee at the local hospital for the purpose ofpresenting the argument for a school board policy to honor Out ofHospital DNR requests for students with life-threateningconditions.
As a member of that ethics committee, how would you respond tothe following question ?
Questions:
1.
1.Why is the school board reluctant to have a policy honoring aDNR?
