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Say a fentanyl user has a highly visible “Do Not Resuscitate” on their person (tattoo, T-shirt, necklace, whatever), and this user is found unconscious in public. Would potential Narcan-appliers be compelled to stand down? If Narcan was used to revive said user, could the reviver be sued or otherwise held liable? —Dean R.
I don’t mean to go all Professor Snape on you, Dean, but your question seems to betray a pretty spotty understanding of both do-not-resuscitate orders and narcotic-antagonist treatments. (Also, your “strength potion” seems to have caused your friend Longbottom here to grow antlers.)
In any case, the answer to both of your questions is probably no. For starters, as a legal matter, “Do Not Resuscitate” does not mean “Do not provide lifesaving care of any kind,” it only means “Do not administer CPR.” And CPR—as I’m sure we all remember from that three-day unit we had in health class in 1989—is only indicated in cases where the patient isn’t breathing and has no heartbeat, a state that less-enlightened generations used to refer to as “dead.”
That’s the point of a DNR. A sufferer who’s successfully departed this vale of tears has the right (if they so choose) not to be dragged kicking and screaming back into it with chest compressions, electric shocks, and breathing tubes. However, that’s not the case in your scenario. Narcan requires circulating blood to work, so if the victim is dead enough for a DNR to kick in, they should be too dead for Narcan to save them.
Granted, things in real life aren’t always so clear-cut. One can imagine edge cases where CPR and Narcan together might bring a deceased opioid victim back around. Also, in practice, doctors may use a subject’s DNR as a proxy for how aggressively to pursue invasive, last-gasp treatment options in general. Luckily, you don’t need to worry about any of that, for one very important reason: You’re not a medical professional, and thus are not bound by legal and ethical standards like honoring someone’s DNR order.
So relax, guy! Under modern Good Samaritan laws, not only will you not be sued for administering Narcan to a fallen addict, you’ll probably be held harmless even if you perform CPR on someone with “Do Not Resuscitate” written across their chest in 2-inch-high neon. For a hospital, something like that could mean a seven-figure “wrongful prolongation of life” judgment, but for a regular schmuck like you? Ten points to Gryffindor!
Questions? Send them to dr.know@wweek.com.
