title: Extenuating circumstances: regarding comfort one: new cardiopulmonary resuscitation directives in South Dakota.
abstract: Circa 2001, Aunt Abby had reached her seventh decade when she was diagnosed with advanced ovarian cancer. Chances of cure were slim to nil, and true to her Midwestern upbringing and staunch faith that a better world awaits, Aunt Abby chose to live out her last months at home, "doing" for Uncle Bill, as she had for the last fifty-two years. Uncle Bill and the kids understood and were willing to abide by her wishes to just let her pass, as God would will. But, when the day came that Aunt Abby's heart failed, she was puttering through the local grocery alone, while Uncle Bill slipped around the corner to pick up parts from the hardware store. An alert store clerk called 911. The EMS team arrived quickly, and, as their protocol required, began resuscitation. Aunt Abby's wish for a death with "no fuss" was no match for the emergency medical system's clinical and legal duty to treat until a physician ordered otherwise.
authors.affiliation: Center for Ethics and Caring, Sioux Valley Hospital, Sioux Falls, SD, USA.
authors.forename: Ellen L
authors.initials: EL
authors.lastname: Schellinger
authors.forename: Mary Helen
authors.initials: MH
authors.lastname: Harris
authors.forename: LuAnn
authors.initials: L
authors.lastname: Eidsness
mesh_terms: D016223:Advance Directives / Q000331:legislation & jurisprudence*; D000368:Aged; D016887:Cardiopulmonary Resuscitation; D005260:Female; D006801:Humans; D013023:South Dakota