Allowing physicians to write a do not resuscitate (DNR) or do not administer cardiopulmonary resuscitation order after properly informing patients and their families that death would be irreversible offers a more rational and compassionate approach than traditional shared decision making in establishing a DNR status for some hospitalized patients.
Get full access to this article
View all access options for this article.
References
1.
BlindermanCD, BillingsJA: Comfort care for patients dying in the hospital. N Engl J Med, 2015; 373:2549–2561.
2.
BekelmanJE, HalpernSD, BlankartCR, et al.: Comparison of site of death, health care utilization, and hospital expenditures for patients dying with cancer in 7 developed countries. JAMA, 2016; 315:272–283.
HeylandDK, IlanR, JiangX, et al.: The prevalence of medical error related to end-of-life communication in Canadian hospitals: Results of a multicentre observational study. BMJ Qual Saf, 2016; 25:671–679.
5.
RosenbaumL: The paternalism preference—Choosing unshared decision making. N Engl J Med, 2015; 373:589–592.
6.
BarnatoAE, ArnoldRM: The effect of emotion and physician communication behaviors on surrogates' life-sustaining treatment decisions: A randomized simulation experiment. Crit Care Med, 2013; 41:1686–1691.
7.
MastersK: My mum's care means that decisions not to resuscitate must now be discussed with patients. BMJ, 2017; 356:j1084.
8.
CoombesR: We need to talk about resuscitation. BMJ, 2017; 356:j1216.
9.
SrivastavaR: The interpreter. N Engl J Med, 2017; 376:812–813.
10.
RobinsonEM, CadgeW, ZollfrankAA, et al.: After the DNR: Surrogates who persist in requesting cardiopulmonary resuscitation. Hastings Cent Rep, 2017; 47:10–19.
11.
Bill C-14: An Act to amend the Criminal Code and to Make Related Amendments to Other Acts (Medical Assistance in Dying). 42nd Parl., 1st sess. Ottawa: Library of Parliament, 2015–2016. Parliament of Canada. Web. February20, 2016.
12.
HeylandDK, DodekP, RockerG, et al.: What matters most in end-of-life care: Perceptions of seriously ill patients and their family members. Can Med Assoc J, 2006; 174:627–633.