Advance Directives and Do-Not-Resuscitate Orders Among Patients With Terminal Cancer in Palliative Care Units in Japan

Abstract

Objective:

To examine the current status of advance directives (ADs) and do-not-resuscitate (DNR) orders among patients with terminal cancer in palliative care units (PCUs) in Japan.

Methods:

We conducted a retrospective chart review of the last 3 consecutive patients who died in 203 PCUs before November 30, 2010.

Results:

The percentages of patients who had ADs during the final hospitalization for cardiopulmonary resuscitation, mechanical ventilation, intravenous fluid administration, tube feeding, antibiotic administration, and who had appointed a health care proxy were 47%, 46%, 42%, 19%, 18%, and 48%, respectively. Seventy-six percent of the patients had a DNR order. Of the patients with decision-making capacity, 68% were involved in the DNR decision.

Conclusions:

These findings may reflect positive changes in patients’ attitudes toward ADs, in Japan.

Keywords

advance directives health care proxy do-not-resuscitate orders palliative medicine palliative care units neoplasms

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