Bioethics Blogs

Ontario Medical Board Cautions Physicians for Writing Unilateral DNR Order (Wawrzyniak v. Chapman & Livingstone)

Various Ontario tribunals have issued quite a few decisions (example) arising out of the civil and administrative complaints filed by Elizabeth Wawrzyniak against several clinicians at Sunnybrook Health Sciences Center involved in the death of her father on September 22, 2008.  The latest one (23 single-spaced pages) was delivered just a few days ago by the College of Physicians and Surgeons of Ontario.

This is the third time that the College has considered the same conduct by the same physicians, but this time with a different result.  Basically, the physicians wrote a DNR order for Douglas DeGuerre without the consent of his substitute decision maker, his daughter.  
The College held

  • The physicians “demonstrated good clinical judgment in determining that extreme measures to preserve life would be futile and would only further exacerbate Mr. DeGuerre’s suffering. . . .  Mr. DeGuerre’s death was inevitable . . . and the actions of [the physicians] . . . did not decrease Mr. DeGuerre’s life span in any meaningful way.”
  • But the College held that the physicians “did not take adequate steps to discuss the proposed change [in code status].  They failed to make “reasonable or sufficient efforts to have a proper discussion with Ms. Wawrzyniak.”
  • Accordingly, the College issued a “written caution” to the physicians “on failing to ensure proper communication with the patient’s SDM.”  
  • The College ordered the physicians to “carefully and fully review the HCCA and provide the Committee with a written report, approximately 2-4 pages in length . . . about what they have learned .

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.