Research article summary:

Do-not-resuscitate order after 25 years.

Abstract Extract:
BACKGROUND: In 1976, the first hospital policies on orders not to resuscitate were published in the medical literature. Since that time, the concept has continued to evolve and evoke much debate. Indeed, few initials in medicine today evoke as much ... (Full abstract text below)

Published 2003May in Journal: Crit Care Med (Language : eng)

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1. Crit Care Med. 2003 May;31(5):1543-50

Do-not-resuscitate order after 25 years.

Burns JP, Edwards J, Johnson J, Cassem NH, Truog RD

Department of Anesthesia, Harvard Medical School, Boston, MA, USA.

BACKGROUND: In 1976, the first hospital policies on orders not to resuscitate were published in the medical literature. Since that time, the concept has continued to evolve and evoke much debate. Indeed, few initials in medicine today evoke as much symbolism or controversy as the Do-Not-Resuscitate (DNR) order. OBJECTIVE: To review the development, implementation, and present standing of the DNR order. DESIGN: Review article. MAIN RESULTS: The DNR order concept brought an open decision-making framework to the resuscitation decision and did much to put appropriate restraint on the universal application of cardiopulmonary resuscitation for the dying patient. Yet, even today, many of the early concerns remain. CONCLUSIONS: After 25 yrs of DNR orders, it remains reasonable to presume consent and attempt resuscitation for people who suffer an unexpected cardiopulmonary arrest or for whom resuscitation may have physiologic effect and for whom no information is available at the time as to their wishes (or those of their surrogate). However, it is not reasonable to continue to rely on such a presumption without promptly and actively seeking to clarify the patient's (or surrogate's) wishes. The DNR order, then, remains an inducement to seek the informed patient's directive.

PMID : 12771631 [PubMed - Indexed for MEDLINE]

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Full Author Information

First Name	LastName	Initials
Jeffrey P	Burns	JP
Jeffrey	Edwards	J
Judith	Johnson	J
Ned H	Cassem	NH
Robert D	Truog	RD

Affiliation: Department of Anesthesia, Harvard Medical School, Boston, MA, USA.

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Category links from this article:

Advance Directives
Decision Making
Forecasting
Humans
Informed Consent
Medical Futility
Organizational Policy
Patient Advocacy
Patient Selection
Practice Guidelines as Topic
Resuscitation - ethics, psychology, trends
Resuscitation Orders - ethics, legislation & jurisprudence, psychology
United States

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