By Jason White 

What may not necessarily be the most exciting topic for the average paramedic or EMT, is a serious issue for many seniors and those with terminal diseases in our state.  Allowing patients to pass with the dignity and respect with which they lived their lives is a critical issue and one that we often do not fully recognize in the EMS world. 

Our training and instinct as EMS professionals naturally make us aggressive with proposing and implementing patient care policies that sustain life. But the act of saving a life (starting IV’s, intubating, etc.) can sometimes have a de-humanizing effect on the dying or terminally ill patient who does not wish to be resuscitated.  It can obviously be upsetting and difficult particularly when this takes place in the home with family nearby. 

Missouri is one of only three or four states in the nation that has not passed some general legislation to create the basic framework for Do-Not-Resuscitate orders in the out-of-hospital environment.  In Kansas City we have worked under a regional protocol since 1994.  This has worked well but for many services in Missouri no such program exists. 

In 2004, the issue of seeking the passage of a DNR bill was brought forward by the End-of-Life Coalition, an organization is comprised of hospice, nursing home and elder care professionals.  Legislation was filed in 2005 and 2006 but did not succeed in passing. 

Through the summer and fall of 2006, meetings were held in Jefferson City consisting of representatives from the End-of-Life Coalition, the Right-to-Life community and the EMS community.  We crafted a bill that everyone either supported or remained neutral on.  Once we had all the stakeholders together in the same room working out the key issues it became a process of settling on language. 

HB 182 was filed by Representative Mark Bruns for consideration by the Missouri General Assembly and has been moving along nicely.  It passed through its committee hearing and then during floor debate in the House, passed 158 to 1.  HB 182 is now waiting for a Senate Committee Hearing. 

An identical version of the bill, SB 658, was filed in the Senate by Senator Bill Stouffer and was heard recently in a Senate Committee which then voted to support the DNR bill. 

If you would like to assist in the passage of this important piece of legislation, please email your state senators (scroll down) and encourage them to support HB 182, as we expect it to be the actual document voted on soon. 

If the bill passes, the Department of Health & Senior Services will develop a DNR form and a task force of nursing home, hospice and EMS professionals will also be formed to assure proper implementation of the new law. For questions regarding HB 182, email Jason White at:  This e-mail address is being protected from spam bots, you need JavaScript enabled to view it