RUMFORD – Arthur Boivin is upset. His ire is directed not at health care workers or emergency responders.
Instead, the Rumford man says help is needed from the Maine Legislature to remedy the problem he’s experienced with living wills.
State Sen. Bruce Bryant, D-Dixfield, has agreed and is now working to correct the statewide problem by drafting a bill, and is asking a legislative committee to examine the issues in the meantime.
On April 24, Boivin’s wife of 42 years, Lyanne, died of stomach cancer. She had put off signing a living will until five days before she died, Boivin said Monday.
That health-care advance directive included her “do not resuscitate” wish. That wish was handwritten by her husband. As required by statute, the document was signed by Lyanne Boivin and two witnesses.
The form also specified that she not be revived when her heart or breathing stopped.
“This form was at my house, and they would not honor it,” Boivin said Thursday.
What the Boivins didn’t know was that the form was worthless.
Maine law requires a separate “do not resuscitate” order or DNR, signed by the person’s attending physician. That “Maine EMS Comfort Care/Do Not Resuscitate Order” is blaze orange and comes with an orange wristband and orange wallet card that quickly alerts emergency first-responders of a DNR order. And, unlike the order the Boivins had, the orange form has no expiration date.
Without the correct form, emergency and other health-care workers were obliged to resuscitate her, regardless of her wishes.
“This is absurd for the state to assume that the individual doesn’t know enough to decide his or her fate,” Boivin said.
What followed when he found out was a last-minute panic to get the right document, get it signed and get back home before his wife died.
Twenty-two days after his wife’s death, Boivin sought help from Bryant to spare someone else the same fate, he said.
“The process doesn’t work right now,” Bryant said Thursday. “It’s been a longstanding issue. It’s more complicated than what it appears to be on the surface, because you have people who want to do a living directive in stages.”
“It’s a major issue, because it involves personal rights, doctors and community health in every community in the state, which operates differently,” he said.
People entering hospice care don’t seem to have a problem, Bryant said.
“But, if they’re in intermittent care, that’s where the problem comes in. The real problem comes when someone hasn’t gone through the process beforehand,” he said.
The state, he said, needs to:
• Authoritatively define the roles of advance directives versus DNR in Maine’s Emergency Medical Service.
• Begin widespread education for health-care providers and the public.
• Re-evaluate the applicability of orders for other than the terminally ill patient, like the competent patient whose doctor agrees, for whatever reason, to issue a Comfort Care/DNR order.
• Examine a uniform Comfort Care/DNR program throughout health-care facilities.
On Thursday, in a letter, he asked the heads of the Joint Standing Committee on the Judiciary, to examine the issues this summer and fall to determine how best to improve the system.
“Whatever the outcome,” he wrote, “there must be universal directives, indicators and policies. One policy should not be in conflict with another.”
“For the sake of the person dying, and their loved ones, as well as first responders and the health-care providers, there must be clear and concise policies in place,” he said.
And that’s what Arthur Boivin said he wants.
“I feel that the patient has to have a right someplace. You certainly don’t need to have a doctor’s permission to die,” he said.
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