Status Code 0
Code 0: No Code = No Care
“Do Not Resuscitate" (DNR) means that a patient who suffers sudden cardiac or respiratory arrest will not receive Cardiopulmonary Resuscitation (CPR). DNR is also referred to as a "No Code"
The Arlene Berry Death Coverup
In a letter to the College of Physicians and Surgeons of Ontario dated November 28, 2000, Dr. Jordan writes "discussed the situation with family members and a decision was made to intubate Ms. Berry", while the Ambulance Call Report seen at N-7 documents an unsigned "Status Code 0", or endorsement of a No Code by proxy. This is an order akin to a 'DNR' denying medical intervention.
Patient condition "Status Code Zero" taken from CMAJ articles, is used to describe a "dead" patient condition. The Yale Law Journal, Vol. 93, No. 2 (Dec., 1983), pp. 362-383, criticizes questionable hospital policies "that resort to third party adjudications in No-Code decision making", and provides insight into the assigning of a "no-code order" instructing personnel "not to attempt resuscitation", as in this case.
In a hospital, an order to withhold resuscitation is commonly called a "no code" (code 0). Only a doctor can write an order for a patient to be a "no code."
A full code is the most extensive course of treatment. It communicates to the physicians that all measures should be taken to keep the patient alive. The patient is only considered safe when his/her code status is full code.
Although it is clear that Arlene Berry was transferred to Sudbury with ventillatory support, and although Drs. Jordan and Spiller were aware of the need for emergency care and life support, after ordering it, they canceled it, using the secretive no code endorsement as a pretext for evoking a declaration of death and in fact waited for the patient's death.
Looking over the chart it is clear that obtaining a 'no code' status in the face of immune mediated adversities by reason of Dr. Jordan's and Dr. Spiller's failure to recognise and treat an emergency situation accordingly, and by reason of Dr. Jordan's failure to attend in a timely manner was the next essential step for these two negligent physicians in executing Arlene Berry's death in order to avoid liability issues. Turn off the respirator and in the natural course of affairs the patient dies from lack of oxygen.
Within a few hours following her transfer from the Kirkland and District Hospital to the Sudbury Regional Hospital Arlene Berry was declared as having met with 'brain death criteria' , while under the care of Drs. Sauve and Adegbite. Her remains were kept in Sudbury for several days prior to being returned to Kirkland Lake.
Withholding life sustaining treatment from an undiagnosed patient with concurrent hyperglycemia, hypokalemia and electrolyte abnormalities in combination with a severely paralysed motor function and who is under the influence of sedative hypnotic and tranquilizing agents is of questionable legality. Death results from respiratory paralysis and subsequent asphyxiation.
Passive euthenasia involves an allowing of "nature to take its course", while active euthenasia consists of killing someone (to do acts causing death), or by choosing not to act is also an act, which determines the course and the outcome of events.
To practice euthenasia by withdrawing life support to a critically ill patient is a medical homicide (to kill or destroy by preventing access of air or oxygen).
When life support is discontinued, death results from respiratory paralysis and subsequent asphyxiation. In the strict medico-legal sense it signifies asphyxia, caused by lack of oxygen or obstruction of the breathing passages.
The clinical diagnosis of brain death in this case was made in the presence of metabolic derangements and endocrine abnormalities and constitutes an act of wanton and reckless disregard for human life.
There have been many challenges to the several concepts of "brain death" and the means of their diagnosis worldwide (vide infra). Indeed, it seems that there is now an emerging consensus that "brain death" diagnosed by any of the protocols in current use worldwide is "not death."
CJNS-Guidelines for the Diagnosis of Brain Death
An act of wanton and reckless disregard for human life is an act of criminal negligence, in this case, causing death. In my opinion, Arlene Berry's death was premeditated, as evidenced by the physician's documented status "Code 0", and Dr. McLellan knowingly returned a false finding for which he remains to be held to account. From the facts of this case it seems clear that this moral compass isn't such a straight arrow after all.
The Criminal Code of Canada regards euthanasia, whether passive or active, as culpable homicide, or murder: A culpable homicide is defined as murder "where the person who causes the death of a human being means to cause his death" (s. 229, Criminal Code of Canada). Unless the law has changed in recent years, euthanasia carries a fixed, minimum penalty of 10 years in prison. euthanasia carries a fixed, minimum penalty of 10 years in prison.
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