Canadian journal of anaesthesia = Journal canadien d'anesthésie
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The background to a current analysis of the management of "do not resuscitate" (DNR) orders in the operating room is reviewed, with an emphasis on the current status of resuscitation/DNR issues in Canada. ⋯ The dominant principle is that of the patient's right to self determination. This right can be exercised either directly by the patient, or through an appropriate alternate, or in the form of an advance directive. DNR orders are not incompatible with subsequent surgical care in an operating room. It is wrong to suspend automatically DNR orders in the perioperative period. It is wrong to continue DNR orders automatically in the perioperative period. It is wrong to make assumptions about the meaning of an individual DNR order. An appropriate approach to the perioperative management of pre-existing DNR orders is one based on "required reconsideration." All anaesthetists must be aware of their responsibilities in managing patients with DNR orders in place.