PATIENTS DISCUSSIONS OF DO-NOT-RESUSCITATE ORDERS

Involving patients in discussions of do-not-resuscitate orders

Involving patients in discussions of do-not-resuscitate orders

Since the advent of various advancements in life saving technologies, interesting ethical issues have arisen with regards to when it is futile to make any additional attempts at trying to resuscitate an individual. The question arises, When is enough, enough? This issue paper discusses the various medical, legal, and ethical questions surrounding the issues involved in the Do Not Resuscitate Order. The problem is: Who should have the final say as to whether a patient is going to allow a Do Not Resuscitate Order? And what kind of care does a patient get when the health care professional does not agree with someone having Full Code Status, instead of a Do Not Resuscitate Order. (Kenworthy, 1999,1-45)

Introduction to the issue: When most people think of a loved one passing him/her usually concern them with the fact that it will be hard to imagine the world without them. For many people the fact that they will not ever get to be with that person again is not all that they must contend with. Since there are many new technologies that increase the likelihood of a person being rescued from some form of arrest there are many additional questions that the family must respond to. These may include the following: When should the patient be considered a Do Not Resuscitate? Who is going to be the person responsible for this order? What are the legal ramifications of the order? Does the American Medical Association give any kind of working definition for a specific case or is each case addressed individually. (Kenworthy, 1999,1-45)

The question of what should be done and how it should directly be addressed, so that in that critical time medical personnel will know how to respond at the appropriate time (Kenworthy, 1999,1-45).

There are a couple of definitions that need to be discussed before a proper understanding can be established. There are several phrases that will be used often in this report. These are the following: Cardiopulmonary Resuscitation (C.P.R.), Do Not Resuscitate (D.N.R.), Advanced Directives, Full Code Status, and Surrogate Decision Maker. (Kenworthy, 1999,1-45)

Cardiopulmonary Resuscitation (CPR) refers to the medical procedures used to restart a patient's heart and breathing when the patient suffers heart failure. CPR may involve simple efforts such as mouth to mouth resuscitation and external chest compression. Advance CPR may involve electric shock, insertion of a tube to open the patients airway, injection of medication into the heart and in extreme cases, open chest heart message(Kenworthy, 1999,1-45).

Do Not Resuscitate (DNR) order tells medical professionals not to perform CPR this means that doctors, nurses and emergency medical personnel will not attempt emergency CPR if the patient's breathing or heartbeat stops.

Advanced Directives: Is not be confused with DNR order. An advanced directive is a legal document that specifies what is to be done by the medical professionals in the case that the patient is unable to participate in any coherent ...