Family consent to orders not resuscitate. Reconsidering hospital policy
J. C. Hackler and F. C. Hiller
Division of Medical Humanities, University of Arkansas for Medical Sciences, Little Rock 72205.
Hospital policies typically require that cardiopulmonary resuscitation be
attempted unless a do-not-resuscitate order has been written, and they
further require that family permission for the order be obtained. This
sometimes forces physicians to perform procedures that are useless or that
add to the patient's suffering without corresponding benefit. Policies
should be changed to allow physicians to write a do-not-resuscitate order
over family objections when (1) the patient lacks decision-making capacity,
(2) the burdens of treatment clearly outweigh the benefits, (3) the
surrogate does not give an appropriate reason in terms of patient values,
preferences, or best interests, and (4) the physician has made serious
efforts to communicate with the family and to mediate the disagreement.
Furthermore, when resuscitation would clearly provide no medical benefit to
the patient, policy should not require that it be discussed with either the
patient or the family.
Should patient consent be required to write a do not resuscitate order?
Biegler
J. Med. Ethics 2003;29:359-363.
ABSTRACT
| FULL TEXT
Conditions and consequences of medical futility--from a literature review to a clinical model
Lofmark and Nilstun
J. Med. Ethics 2002;28:115-119.
ABSTRACT
| FULL TEXT
Language and Reality at the End of Life
Cohen-Almagor
J Law Med Ethics 2000;28:267-278.
Futilitarianism: knowing how much is enough in end-of-life health care
Dunphy
Palliat Med 2000;14:313-322.
ABSTRACT
Not for Resuscitation: two decades of challenge for nursing ethics and practice
Schultz
Nurs Ethics 1997;4:227-238.
ABSTRACT
Recommended Guidelines for Reviewing, Reporting, and Conducting Research on In-Hospital Resuscitation: The In-Hospital `Utstein Style' : A Statement for Healthcare Professionals From the American Heart Association, the European Resuscitation Council, the Heart and Stroke Foundation of Canada, the Australian Resuscitation Council, and the Resuscitation Councils of Southern Africa
Cummins et al.
Circulation 1997;95:2213-2239.
FULL TEXT
Resuscitation Policy Concerning Older Adults: Ethical Considerations of Paternalism Versus Autonomy
Teaster
Journal of Applied Gerontology 1995;14:78-92.
ABSTRACT