Unilateral Do Not Resuscitate Orders (DNR)

Paper Summary:

This paper discusses unilateral DNR, or do-not-resuscitate orders, placed in the chart of patients without the consent of the patient or the patient's family. They are used when CPR would be futile. The paper then describes the ethical controversy involved with this issue--that many fear physicians could abuse this practice. The author argues that policies must be in place to safeguard against abuse. A model unilateral DNR policy is presented.

Outline:
Introduction
Review of Literature and Analysis
Explore Options
Apply Rule Ethics
Position
Considerations For Practice
Conclusion

From the Paper:

"In the early 1960s, CPR or cardiopulmonary resuscitation came into use. CPR was originally developed for patients who suffered a cardiac arrest secondary to anesthesia. The practice of CPR quickly became the standard of care for all patients suffering cardiac arrest. With advancements in technology the norm has become aggressive treatment until death. From the earliest days of CPR, few issues have been more contentious than whether a physician may determine, without patient or surrogate consent, that CPR is not indicated(Leonard, 1999). According to the Journal of Critical Care Medicine, by the late 1960s articles began to appear in medical literature, which described the agony many terminally ill patients experienced from repeated resuscitations that only prolonged their death (Burns, 2003). Because of the suffering caused by CPR performed on patients with terminal illnesses, hospital staff began using the unethical practice of slow codes or show codes. Orders not to resuscitate evolved in the early 1970s."

Sample of Sources Used:

• American Medical Association (1994). Current opinions. Retrieved March 8, 2006 from http://web.utk.edu/~ggraber/limits/why2.htm
• Burns, J.P., Edwards, J., Johnson, J., Cassem, N.H., and Truog, R.D. (2003). Do-not-resuscitate order after 25 years. Journal of the Society of Critical Care Medicine, 31(5), 1543-1550. Retrieved March 21, 2006 from http://ezproxy.ttuhsc.edu:3121/gw2/ovidweb.cgi
• Doty, W.D. and Walker, R.M.(2000). Medical futility. Clinical Cardiology, 23, II6-II16. Retrieved March 30, 2006 from http://www.clinicalcardiology.org/productcart/pc/supplements/CC23S2/cc23s2.doty.html
• Leonard, C.T., Doyle, R.L., and Raffin, T.A.(1999). Do-not-resuscitate orders in the face of patient and family opposition. Journal of the Society of Critical Care Medicine, 27(6), 1045-1047. Retrieved March 30, 2006 from http://ezproxy.ttuhsc.edu:3121/gw2/ovidweb.cgi
• Paris, J.J., Singh, J., Schreiber, M.D., and Reardon, F.E. (1999). Unilateral do-not-resuscitate orders in the neonatal intensive care unit. Journal of Perinatology, 19(5) 383-387.

More papers on Unilateral Do Not Resuscitate Orders (DNR):

• Argumentative Essay # 63540 : "A "Do-Not-Resuscitate" - DNR Order"
• Argumentative Essay # 69029 : "The Do-Not-Resuscitate Policy"
• Term Paper # 93859 : "Do Not Resuscitate Orders"
• Essay # 27404 : "Do Not Resuscitate and Ethics"

APA Citation:

MLA Citation: