• Aart Osinski, Gerard Vreugdenhil, de Koning Jan J Department of Intensive Care Medicine, Maxima Medical Centre, De Run 4600, 5504DB, Veldhoven, the Netherlands., and Johannes G van der Hoeven.
• Department of Internal Medicine, Maxima Medical Centre, De Run 4600, 5504DB, Veldhoven, the Netherlands. aart_osinski@hotmail.com.
• Support Care Cancer. 2017 Feb 1; 25 (2): 677-685.

AbstractDiscussing do-not-resuscitate (DNR) orders is part of daily hospital practice in oncology departments. Several medical factors and patient characteristics are associated with issuing DNR orders in cancer patients. DNR orders are often placed late in the disease process. This may be a cause for disagreements between doctors and between doctors and patients and may cause for unnecessary treatments and admissions. In addition, DNR orders on itself may influence the rest of the medical treatment for patients. We present recommendations for discussing DNR orders and medical futility in practice through shared decision-making. Prospective studies are needed to investigate in which a patient's cardiopulmonary resuscitation (CPR) is futile and whether or not DNR orders influence the medical care of patients.

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