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    Do Not Resuscitate Orders: Among Physicians, Nurses, Patients and Relatives

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    Salman Habeeb
    The document discusses ethical aspects of do-not-resuscitate orders and decision making. It analyzes questionnaires and interviews with physicians, nurses, patients, and relatives. It finds discrepancies between guidelines and attitudes regarding DNR orders. Patients value open communication about end of life treatments. Relatives felt they received adequate information. The conclusion calls for early conversations with chronically ill patients and their families about end of life support and making joint decisions.

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    Do Not Resuscitate Orders: Among Physicians, Nurses, Patients and Relatives

    Uploaded by

    Salman Habeeb
    48 views4 pages
    The document discusses ethical aspects of do-not-resuscitate orders and decision making. It analyzes questionnaires and interviews with physicians, nurses, patients, and relatives. It finds discrepancies between guidelines and attitudes regarding DNR orders. Patients value open communication about end of life treatments. Relatives felt they received adequate information. The conclusion calls for early conversations with chronically ill patients and their families about end of life support and making joint decisions.

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    The document discusses ethical aspects of do-not-resuscitate orders and decision making. It analyzes questionnaires and interviews with physicians, nurses, patients, and relatives. It finds discrepancies between guidelines and attitudes regarding DNR orders. Patients value open communication about end of life treatments. Relatives felt they received adequate information. The conclusion calls for early conversations with chronically ill patients and their families about end of life support and making joint decisions.

    Copyright:

    © All Rights Reserved
    Download as RTF, PDF, TXT or read online from Scribd
    Download as rtf, pdf, or txt
    48 views4 pages

    Do Not Resuscitate Orders: Among Physicians, Nurses, Patients and Relatives

    Uploaded by

    Salman Habeeb
    The document discusses ethical aspects of do-not-resuscitate orders and decision making. It analyzes questionnaires and interviews with physicians, nurses, patients, and relatives. It finds discrepancies between guidelines and attitudes regarding DNR orders. Patients value open communication about end of life treatments. Relatives felt they received adequate information. The conclusion calls for early conversations with chronically ill patients and their families about end of life support and making joint decisions.

    Copyright:

    © All Rights Reserved
    Download as RTF, PDF, TXT or read online from Scribd
    Download as rtf, pdf, or txt
    of 4

    Donotresuscitateorders

    Ethicalaspectsondecisionmakingandcommunication

    amongphysicians,nurses,patientsandrelatives

    BY

    RURIKLFMARK

    .ABSTRACT
    LfmarkRurik. Donotresuscitateorders.Ethicalaspectsondecisionmakingand
    communicationamongphysicians,nurses,patientsandrelatives.
    ISBN9162845284
    Thepurposewastodescribeethicalaspectsonhowdonotresuscitate(DNR)deci
    sionsaremade,established,andcommunicatedbetweenphysicians,nurses,patientsand
    relatives.
    Arandomsampleof220physiciansandnursesansweredaquestionnaireabouttheir
    attitudestoandexperiencesofthemakingandcommunicationofaDNRdecision.The
    responseratewas73%.Twentyseriouslyillpatients,and21relativesofpatientswho
    died with a DNR order, were interviewed. The literature on medical futility was
    searchedforconditionsforfutilityandmoralconsequences.
    Theresultsshowedthatmanyphysiciansandnursesareuncertainabouttherulesand
    ethics of DNR orders. There are discrepancies between guidelines and attitudes
    regardingDNRorders,aswellasbetweenattitudesandbehaviour.Seriouslyillpatients
    estimateopenandstraightforwardconversations abouttreatments intheendoflife.
    Relatives seem to get acceptable information and counselling. Conditions and
    consequencesofmedicalfutilitymaybeapproachedinanewclinicalway.Thereare
    numerouspossibleethicalconflictswithinandbetweentheprinciplesofautonomy,
    nonmaleficence,beneficence,andthevirtuesandidealsoftheprofession.
    Startadialogueaboutendoflifesupportwithchronicallyillandelderlypatients,and
    theirrelatives,whiletheystillarecapableofunderstandingandauthorisation.Theclinical
    conversationmodelmaymakeiteasier.Allinvolvedshouldunderstandwhycertaindeci
    sionsaremade.Conditionsandconsequencesoffutilityshouldbeascertainedtogetherwith
    thepatients,therelativesandthestaff,afterwhichajointdecisioncanbereached.

    Key words: DNR orders, futility, decision making, communication, physicians,


    nurses,patients,relatives,ethics

    RurikLfmark,DepartmentofMedicalEthics,Facultyofmedicine,Lund
    University,SE22222Lund,Sweden.Email:[email protected]

    RurikLfmark2001
    PrintedinSwedenbyUniversitetstryckeriet,Lund2000
    2

    ORIGINALPAPERS
    Thedissertationisbasedonthefollowingpapers,whichwillbereferredtointhe
    textbytheirromannumerals:
    I

    LfmarkR,NilstunT.DoNotResuscitateordersshouldthepatientsbein
    formed?JInternMed1997;241:4215

    35 LfmarkR,NilstunT.Decidingnottoresuscitate.Responsibilitiesofphysicians
    andnursesaproposal.ScandJCaringSci1997;11:20711
    61 LfmarkR,NilstunT.InformingpatientsandrelativesaboutDoNotResuscitate
    decisions.JInternMed1998;243:1915
    IVLfmarkR,NilstunT.Notif,buthow:onewaytotalkwithpatientsaboutforgoing

    lifesupport.PostgradMedJ2000;76:2628
    22 LfmarkR,NilstunT.Experiencesandattitudesofrelatives:expectationsofcare
    arefirmanddiverse,butdonotresuscitateordersarealmostinvisible.Submitted
    forpublication.
    VI LfmarkR,NilstunT.Conditionsandconsequencesofmedicalfutilitya
    proposalforanewclinicalapproach.Submittedforpublication.

    Reprintsweremadewithkindpermissionfromthepublishers.

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