• J Healthc Risk Manag · Jan 2013

    Advance directives in the perioperative setting: Managing ethical and legal issues when patient rights and perceived obligations of the healthcare provider conflict.

    • Stephen P Williams and Christopher L Howe.
    • Haynsworth Sinkler, Boyd, PA, USA.
    • J Healthc Risk Manag. 2013 Jan 1;32(4):35-42.

    AbstractPerhaps individual wishes are not always acknowledged or accepted when it comes to end-of-life care. This possibility, in conjunction with the experiences of healthcare risk managers, should cause concern in the healthcare risk management community. One particularly concerning issue where a persistent failure to honor a patient's wishes exists is with Do Not Resuscitate (DNR) orders in the perioperative arena. Despite a strong focus on informed consent and advance directives, evidence suggests a number of healthcare organizations either have no policy in place regarding DNR orders during the perioperative period, or, for those organizations that do have a policy, many call for automatic suspension of the DNR order without consultation with the patient. This latter practice poses many ethical, medico-legal, and regulatory concerns, and healthcare organizations with such a policy in place should strongly consider revisiting this practice.© 2013 American Society for Healthcare Risk Management of the American Hospital Association.

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