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N.M. District Affirms Policy on CPR for Terminally Ill Students

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School officials in Albuquerque, N.M., will continue allowing educators to perform CPR on gravely ill students whose parents and physician have signed "withhold" orders requesting them not to.

The Albuquerque school board has an informal directive that calls for educators to heed the "do not resuscitate" orders, but the district traditionally has not followed it. The school board voted 4-2 last week to maintain the status quo, despite the recommendations of a committee of school officials and local medical professionals that urged the district to enforce the directive.

In some instances, parents of seriously ill students do not want the children to receive cardiopulmonary resuscitation in the case of respiratory or cardiac arrest.

In recent years, many school districts around the country have faced the difficult question of whether educators should make the decision to let a child die, and several have declined to acknowledge the withhold orders. ("District Decides To Provide Life-Sustaining Care to All," Dec. 16, 1992.)

Request From Parents

The issue arose in Albuquerque after some parents of students with life-threatening medical conditions recently discovered that the 90,000-student district would not honor their withhold orders and asked the school board to reconsider.

Kathryn Braziel, the district's director of student services, was a member of the committee that urged the district to begin following parents' wishes. "The school district is at great risk legally for taking the stance it has taken," she said last week.

In Albuquerque, cases in which students have such orders are rare--only two in the last three years--and there have been no instances where those students have required CPR, Ms. Braziel said.

Under the district's current practice, if a student were to be stricken at school, CPR would automatically be performed regardless of a do-not-resuscitate order.

Board member Mary Lee Martin was one of the minority that voted to follow the parents' wishes. "It's one of those issues where there is no compromise," she said. "You either believe in it or you don't."

Ms. Martin said the decision of whether to resuscitate a child should be left in the hands of parents. "Parents are asking for this change," she said.

The National Association of School Nurses, based in Scarborough, Maine, recommends that do-not-resuscitate orders for medically fragile students be evaluated on an individual basis at the local level.

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