• Journal of medical ethics · Oct 2010

    Ethical issues surrounding do not attempt resuscitation orders: decisions, discussions and deleterious effects.

    • Zoë Fritz and Jonathan Fuld.
    • Department of Acute Medicine, Cambridge University NHS Foundation Trust, Box 275, Hills Road, Cambridge, CB2 0QQ, UK. zoefritz@gmail.com
    • J Med Ethics. 2010 Oct 1;36(10):593-7.

    AbstractSince their introduction as 'no code' in the 1980s and their later formalization to 'do not resuscitate' orders, such directions to withhold potentially life-extending treatments have been accompanied by multiple ethical issues. The arguments for when and why to instigate such orders are explored, including a consideration of the concept of futility, allocation of healthcare resources, and reaching a balance between quality of life and quality of death. The merits and perils of discussing such decisions with patients and/or their relatives are reviewed and the unintended implications of 'do not attempt resuscitation' orders are examined. Finally, the paper explores some alternative methods to approaching the resuscitation decision, and calls for empirical evaluation of such methods that may reduce the ethical dilemmas physicians currently face.

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