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Earlier this year an elderly woman with advanced cancer arrived in our Emergency Department from a nursing facility where she had developed a fever and respiratory distress. She was critically ill, and unable to express her own wishes about what we should do. The information we had fom her nursing facility was that she was “full code,” although during a recent hospitalization here she and her physicians had agreed on a “DNAR” (Do Not Attempt Resuscitation) order. And even though she had been our patient in the past, staff in the ED had no documentation of her having a health care proxy, so they had no one they could clearly turn to to ask what she would want us to do.
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