Question: Can you explain what this part in the consent section means? It seems to give more flexibility to not begin resuscitation based on family members who seem reliable saying that that is what the patient wanted. "If a paramedic is aware or is made aware that the person has a prior capable wish with respect to treatment, they must respect that wish (for example, if the person does not wish to be resuscitated)."
First, thanks for reading the pre-amble/introduction!
The goal of reviewing consent in this section was not to "sneak in under the radar" a change in process for approaching resuscitations. In fact, no change in process from previous is implied with the statement. To be clear, while above you quote verbatim the statement as it appears in the introduction on page 6, on the actual document, there is no mention of "not beginning resuscitation based upon family members who seem reliable".
The process for a paramedic to withhold initiating resuscitation is clearly outlined in the DNR Standard training bulletin. This document can be found here:
This exact situation is reviewed in the Training Bulletin produced by MOHLTC in Appendix 2 named ironically Frequently Asked Questions. Question 17 on page 26 states: "For the paramedic or firefighter to not perform CPR on a patient who is in respiratory or cardiorespiratory arrest, he/she MUST receive a fully completed DNR Confirmation Form. This Form is the only directive that gives permission to paramedics and firefighters to not perform CPR on patients who have a DNR order and have experienced respiratory or cardiorespiratory arrest"