Cardiopulmonary resuscitation and do-not-resuscitate orders: a guide for clinicians
- PMID: 20102982
- DOI: 10.1016/j.amjmed.2009.05.029
Cardiopulmonary resuscitation and do-not-resuscitate orders: a guide for clinicians
Abstract
The do-not-resuscitate order, introduced nearly a half century ago, continues to raise questions and controversy among health care providers and patients. In today's society, the expectation and availability of medical interventions, including at the end of life, have rendered the do-not-resuscitate order particularly relevant. The do-not-resuscitate order is the only order that requires patient consent to prevent a medical procedure from being performed; therefore, informed code status discussions between physicians and patients are especially important. Epidemiologic studies have informed our understanding of resuscitation outcomes; however, patient, provider, and institutional characteristics account for great variability in the prevalence of do-not-resuscitate orders. Specific strategies can improve the quality of code status conversations and enhance end-of-life care planning. In this article, we review the history, epidemiology, and determinants of do-not-resuscitate orders, as well as frequently encountered questions and recommended strategies for discussing this important topic with patients.
Copyright 2010. Published by Elsevier Inc.
Similar articles
-
Restricting CPR to patients who provide informed consent will not permit physicians to unilaterally refuse requested CPR.Am J Bioeth. 2010 Jan;10(1):82-3. doi: 10.1080/15265160903460996. Am J Bioeth. 2010. PMID: 20077353 No abstract available.
-
The conversation around CPR/DNR should not be revived--at least for now.Am J Bioeth. 2010 Jan;10(1):84-5. doi: 10.1080/15265160903460988. Am J Bioeth. 2010. PMID: 20077354 No abstract available.
-
Must consent always be obtained for a do-not-resuscitate order?Arch Intern Med. 1996 Dec 9-23;156(22):2617-20. Arch Intern Med. 1996. PMID: 8951306
-
[Cardiopulmonary resuscitation and do not resuscitate orders].Rev Med Chil. 2007 May;135(5):669-79. Epub 2007 Jul 9. Rev Med Chil. 2007. PMID: 17657338 Review. Spanish.
-
[Do-not-resuscitate orders--ethical and legal considerations].Ugeskr Laeger. 2007 Mar 26;169(13):1201-4. Ugeskr Laeger. 2007. PMID: 17425922 Review. Danish.
Cited by
-
Code status discussions between attending hospitalist physicians and medical patients at hospital admission.J Gen Intern Med. 2011 Apr;26(4):359-66. doi: 10.1007/s11606-010-1568-6. Epub 2010 Nov 20. J Gen Intern Med. 2011. PMID: 21104036 Free PMC article.
-
Seriously ill hospitalized patients' perspectives on the benefits and harms of two models of hospital CPR discussions.Patient Educ Couns. 2013 Dec;93(3):633-40. doi: 10.1016/j.pec.2013.08.003. Epub 2013 Aug 19. Patient Educ Couns. 2013. PMID: 24005002 Free PMC article.
-
Do-(Not-)Mechanical-Circulatory-Support Orders: Should We Ask All Cardiac Surgery Patients for Informed Consent for Post-Cardiotomy Extracorporeal Life Circulatory Support?J Clin Med. 2021 Jan 20;10(3):383. doi: 10.3390/jcm10030383. J Clin Med. 2021. PMID: 33498412 Free PMC article. Review.
-
Comprehensive geriatric assessment as an essential tool to register or update DNR codes in a tertiary care hospital.Eur Geriatr Med. 2024 Apr;15(2):295-303. doi: 10.1007/s41999-023-00925-4. Epub 2024 Jan 26. Eur Geriatr Med. 2024. PMID: 38277096
-
Do-Not-Resuscitate status as an independent risk factor for patients undergoing surgery for hip fracture.World J Orthop. 2017 Dec 18;8(12):902-912. doi: 10.5312/wjo.v8.i12.902. eCollection 2017 Dec 18. World J Orthop. 2017. PMID: 29312849 Free PMC article.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Medical
