Journal of medical ethics
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Journal of medical ethics · Aug 2008
ReviewEthical dilemmas in palliative care in traditional developing societies, with special reference to the Indian setting.
There are intriguing and challenging ethical dilemmas in the practice of palliative care in a traditional developing society. ⋯ The four principles of ethics posed difficulties in understanding the complex ethical issues in a developing country with a traditional background. Ethical issues need to be handled delicately and sensitively in palliative care settings, within the framework of the traditions and culture of the society and financial constraints. The possible role of ethics committees in palliative care settings to help decision-making needs to be studied and discussed.
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Journal of medical ethics · Aug 2008
Patients' attitudes towards "do not attempt resuscitation" status.
The decision of "do not attempt resuscitation" (DNAR) in the event of cardiopulmonary arrest is usually made when the patients are critically ill and cannot make an informed choice. Although, various professional bodies have published guidelines, little is know about the patients' own views regarding DNAR discussion. ⋯ This study suggests that contrary to current practice most patients want to discuss their DNAR status prior to becoming critically ill. This includes half of the small number that find it distressing to discuss. Although most patients are comfortable with relatives being involved in discussing DNAR, a significant proportion do not want their relatives to be asked. Furthermore, once a decision has been made, the majority of patients want it to be more accessible than current practice allows.