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In the summer of 1981, I learned that a do-not-resuscitate (DNR) order can be in the best interests of a child.
I was working--not in my current state--as a teacher in a residential center for severely disabled children. Of the dozen children I taught that summer, two died--right in my classroom. One had a DNR order, the other did not. The differences in their deaths were instructive.
Both students were nine-year-old boys. One, whom I'll call Michael, was dying from a genetic disorder that destroyed his muscle tone and speech. Michael had a DNR order, as at his regular school.
All of us at the summer session were trained in how to honor the order. Michael's parents attended some sessions, and his doctor came to tell us how to recognize a cardiac arrest, the event to which a DNR order applies.
Cardiac arrest has been defined as "the sudden unexpected cessation of heartbeat and blood pressure. It leads to loss of consciousness within seconds, irreversible brain damage in as little as three minutes, death within four to 15 minutes."
You try to reverse cardiac arrest by administering cardiopulmonary resuscitation (CPR). A DNR order means simply: don't do CPR. In a school, responsible staff members must carry out all other emergency procedures, however, including signaling the administration, calling 911, calling the parents--and offering comfort to the child.
Michael suffered his cardiac arrest in August. I was sitting next to him. His body jerked, and immediately I could see his color pale. He showed no signs of respiratory distress. Instead he was quiet, displaying the symptoms his doctor had described of cardiac arrest.
I signaled the administration by yelling Michael's name to an aide who was stationed in the hall outside my door. Then I took Michael from his wheelchair and put him on my lap. I spoke comforting words; his body relaxed.
Within minutes. the emergency medical personnel arrived. The medics scooped him up from my arms, but did not start CPR--they were shown...