Abstract
This paper examines the ongoing and controversial debate regarding euthanasia. This paper discusses the rights of terminally ill patients who opt to refuse treatment as well as the various legal and moral ramifications surrounding this particular topic. This paper delves into the views, policies and cost control measures of health insurance companies regarding DNR policies. This paper discusses both sides of the assisted suicide issue as it pertains to terminally ill individuals. This paper explores the medical community's reputation related to the improving quality of care given to terminally ill patients. This paper discusses the medical community's concern regarding inherent or potential disciplinary actions, malpractice liability as well as criminal prosecution surrounding physician assisted suicide. This paper also analyzes the existing yet contradicting laws which give patients the right to accept or refuse care yet do not encompass the rights of those actually delivering the care.

Table of Contents:
Introduction
Arguments For
Arguments Against
Conclusion
References

From the Paper
"Consider that the United States healthcare system includes many health plans, physicians, hospitals, clinics, consumers, and public health programs. These entities are all usually focused on life and health recovery. But, the healthcare community also incorporates a very large hospice aspect which is utilized by both insured and uninsured patients that are terminally ill. As our nation's median age of the overall population steadily rises, more Americans will need the services provided by hospice organizations - or, they should be allowed to choose the option of do-not-resuscitate or "Right to Die" as valid approaches to end stage life. Once patients are to a point where they can be assured that there are no possibilities and or options left for curing their fatal disease for example, allowing the end to come more naturally may actually be more humane. This approach relieves many burdens such as when a financial burden is inadvertently put on the surviving family if life is extended artificially."

Tags:medical, legal, ethics, morals, euthanasia, death, health, nurses, nursing

Abstract
This paper explains why it is unethical and impractical to expect people to sign a DNR order as part of their health care plan when, at the time of signing, they are perfectly healthy. It uses real medical cases illustrating why doing so is problematic and to argue that DNRs, while justified at times, can often be unsuitable for persons to specify in advance for any medical condition that may arise.

From the Paper
"A 'Do-Not-Resuscitate' - DNR Order from an adult patient directs the medical staff not to attempt to restore the patient if his breathing or heartbeat has blocked. This means that doctors, nurses and other health care practitioners will not start emergency procedures like mouth-to-mouth resuscitation, external chest compression, electric shock, and insertion of a tube to open your airway, injection of medication into your heart or open chest. Additionally, the Health Care Proxy Law permits an adult patient to employ someone to make decisions about DNR and other treatments if the patient is not capable of doing the same. Cardiopulmonary resuscitation - CPR refers to the medical procedures employed to revive a patient's heart and breathing when the patient experiences heart failure. CPR may include minor efforts such as mouth-to-mouth resuscitation and external chest compression. Sophisticated CPR may include electric shocks, inserting of a tube to open the patient's airway, injecting medication into the heart and in complex difficult cases, open chest heart massage. "

Tags:cpr, hospital, nursing, home, medical, staff, cardiac, arrest, emergency, urgent, breathing

Abstract
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."

Tags:do-not-resuscitate, orders, DNR, CPR, medical, ethics

Abstract
This paper describes how the process of do not resuscitate (DNR) can be the source of an ethical dilemma for healthcare workers. The writer discusses a specific case that arose at Euclid Hospital that shows how nurses can be torn between their loyalty to the patient and to hospital policy. Euclid Hospital's risk management policy and ethical decision-making model are also described. The writer concludes that ethical dilemmas can be resolved by improved communication and by assessing each case individually.

Outline:
Introduction
Do Not Resuscitate
Policy vs. Patient Care
Ethical Responses
Risk Management
Ethical Decision Making Model
Conclusion

From the Paper
"The primary nurse for this patient did initiate CPR. Family was not present and within two minutes the house physician was on the unit and a DNR order was written and life sustaining efforts ceased. The primary nurse in this situation acted under the ethical precept of deontology. Deontology is one system of ethical decision making. The theory is based on moral rules and unchanging principles. Deontology is based on the belief of standards present for the ethical choices and judgments that nurses make (Aiken, 2004). This approach would justify the nurse initiating CPR on this patient because she was following legal and professional rules."

Tags:nonmaleficence litigation, intensive care unit, clinician, healthcare provider, caregiver

Abstract
This paper introduces, discusses and analyzes the topic of do not resuscitate (DNR) orders and living wills (also known as "advance directives"). Specifically, it discusses the ethics of these orders and how they relate to medical law and professional ethics. The paper looks briefly at where patient rights and medical ethics blend and where they diverge.

Table of Contents:
Introduction
Body
Conclusion
Definitions

From the Paper
"Ultimately, the woman's condition deteriorated, and she died within 24 hours of the first legal and medical meeting regarding her case. However, the problem brings up many ethical questions. Who is ultimately responsible for advance directive orders? In this case, the woman could not speak for herself, and the closest relative was her husband, who made his wishes clearly known. However, the rights of the fetus also had to be considered. The authors of the case study note, "However, the rights of the unborn are still widely debated, and it is far less obvious that they can outweigh the well-established right of competent adults to be free of unwanted and burdensome medical treatment". This ethical question is difficult to decide, and even more difficult to implement. In this case, the doctor felt giving CPR to the woman would only prolong her life for perhaps minutes or hours, and would do nothing to greatly prolong her life and the life of her unborn child. If the age of the fetus had been different, this case probably would have ended in the courts."

Tags:medical, treatment, suffering, prolong

Abstract
This paper explores the issue of "Do Not Resuscitate" orders, commonly known as DNR's. While the main issue discusses the legal ramifications, there are other issues raised such as the use of health care resources and the ethical consequences of the inaction. The paper defines DNR as "if the patient's heart stops, there will be no efforts to revive that patient", in other words the patient will simply be allowed to die naturally, with no medical intervention.

From the Paper
"The first step here is to clarify what the "do not resuscitate" order means. It means that if the patient's heart stops, there will be no efforts to revive that patient. The patient will simply be allowed to die naturally, with no medical intervention. The Royal College of Nursing, along with other professional organizations, noted that these orders are important documents that should only be considered after discussion with the patient and family members or others close to the patient."

Tags:health, care, nurse, doctor, illness, sick, dying, hospital, legal, medical, ethics

Abstract
This paper explains that, although living wills and "Do Not Resuscitate" (DNR) orders are common methods used by patients and their families to indicate their wishes during times of hospitalization and treatment, there are so many exceptional cases and circumstances surrounding these issues that they are continually controversial and test the bio-ethical standards of the medical and legal communities. The author points out that, while every state now recognizes advance directives and DNRs, they can be interpreted differently in each state due to laws and legislation. The author also explains that many physicians, fearful of legal reprisals, judge each advance directive on a case-by-case basis and are reluctant to abide by the directives if the case is even the slightest bit unusual or questionable.

From the Paper
"To a family member or patient, the idea of a Living Will or "Do Not Resuscitate" order many seem binding and unquestionable. However, many circumstances challenge these orders, and the ethics of carrying them out are sometimes convoluted and questionable. For example, one cited case involved a 21-year old pregnant female diagnosed with "PCP (pneumocystis carinii pneumonia), right parietal infarct (a blood clot in her brain) with left hemiplegia, and CMV (cytomegalovirus, an infection similar to mononucleosis)". It was discovered the woman was also HIV-positive, and there was a great possibility her unborn child was also HIV-positive."

Tags:binding, wishes, interpretation, case-by-case

Abstract
An illustration of the Do Not Resuscitate or DNR orders, as they are known as in the abbreviated form.

Tags:do, not, resuscitate

Abstract
The paper relates that the true work of a nurse of invisible-patient care is actually a small part of a nurse's daily responsibilities. "If we cannot name it (nursing) we cannot control it, teach it, finance it, research it, or put it into public policy" (Swan, Lang, and McGinley, 2004). The paper argues that the only way for the quality of patient care to be consistent, identifiable and measurable is through a unified or standardized language. The paper contends that this standardized language must be used across the board to describe patient care and to take advantage of the technology systems available in clinical care (Swan, Lang, and McGinley, 2004).

From the Paper
"The true work of a nurse is invisible--patient care is actually a small part of a nurse's daily responsibilities. "If we cannot name it (nursing) we cannot control it, teach it, finance it, research it, or put it into public policy" (Swan, Lang, and McGinley, 2004). The only way for the quality of patient care to be consistent, identifiable and measurable is through a unified or standardized language. This standardized language must be used across the board to describe patient care and to take advantage of the technology systems available in clinical care (Swan,...)"

Tags:dnr, nursing, communication

Abstract
This essay discusses how do not resuscitate (DNR) decisions from a patient standpoint can be proven morally and ethically upon examination through the principles of utilitarianism. The examples of John Stuart Mill and Jeremy Bentham epitomize this reality.

Tags:utilitarianism, dnr, decisions