In Reversal, Me. District Honors 'Do Not Resuscitate' Order
The Lewiston, Me., school board has voted to honor a mother's request that school employees not attempt to resuscitate her severely disabled daughter in a medical emergency.
The board's action last month would not prevent outside medical technicians from providing cardiopulmonary resuscitation. Nevertheless, the decision has stirred controversy over the issue of how schools should respond to the needs of the growing number of "medically fragile'' students in classrooms.
The issue in Lewiston began when a pediatrician treating Corey Brown, a 12-year-old whose spastic cerebral palsy and severe scoliosis make it difficult for her to breathe, requested that school personnel be instructed not to try to revive the girl if her heart stopped beating.
Lewiston board members initially declined to accept the "do not resuscitate'' order sought by the girl's mother. The panel last month reversed its position, however, and voted in favor of a provision banning C.P.R. for Corey.
If she goes into cardiac arrest, however, school personnel will be permitted to call emergency medical technicians, who will not be obligated under the board policy to abstain from resuscitation, said Robert V. Connors, the superintendent of schools.
Board members said they had been told that the child's fragile chest made C.P.R. hazardous to her. The C.P.R. technique, which involves pushing on the chest, is increasingly viewed as inhumane for patients with painful terminal illnesses.
This week, the board will consider a new policy developed by Mr. Connors that would require school staff members to administer life-sustaining care, including the stoppage of bleeding and C.P.R., to any student in need, regardless of parents' and doctors' wishes. The new policy would allow individual exemptions, however.
'We're Not Equipped'
Mr. Connors said he initially denied Corey's do-not-resuscitate order because he was "not comfortable'' with allowing school personnel, who may have little or no medical training, to decide when it would be appropriate to allow a child to die. After increased pressure from the child's doctor, however, he had the request submitted to the school board.
Brad Boutilier, the chairman of the school board and an opponent of the do-not-resuscitate order, said board members who had backed the ban failed to understand the larger issue of the status of medically fragile children in the public school system.
"They didn't seem to understand that we're not equipped now to handle medically fragile kids,'' Mr. Boutilier said.
Mr. Boutilier warned of the potential emotional trauma other students might experience at the sight of a child dying, unaided by the adults in the classroom.
Mr. Boutilier also argued that honoring one parental request to deny C.P.R. might open the door for other parents to demand extraordinary measures to save their children.
The Lewiston decision follows policies adopted last year by two other Maine districts, Bangor and East Holden, which experts said were among the first in the nation to require school personnel to provide life-sustaining emergency care to students regardless of parental requests. (See Education Week, Dec. 16, 1992.)