Why is the doctor not discussing things directly with the patient? (If I were the patient, I'd be seriously pissed if a doctor went behind my back to a family member UNLESS I were incompetent, in which case, I'd be incompetent. Is that the case here?)

I'd get the family together with the doctor and have the discussion. Yes, it's hard. BUT, a doctor can explain what happens when they start doing all the electronic shocking and stuff, and how very few people (of any age) leave the hospital (even if they were inside already when the code was called).

I've heard about lots of broken ribs, and about a 15% chance of success (=leaving the hospital alive) at best. It doesn't sound like a good way to go at all.

BUT, the doctor can also help you get the directives so there's pain management and so on.

Editing to add: /comfort to Mr. Silver. These discussions are incredibly hard all the way around, and I'm sorry that you have to face this. I'm glad you have Silver's support, though, and wish you all well working together.