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Robert M. Veatch, MD
Joseph and Rose Kennedy Institute of Ethics Georgetown University Washington, DC

JAMA. 1986;255(21):2897.

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In Reply.—

I am grateful that Drs Grattan, Peterson, and Blakley took the time to think about the term "doctor's orders" and to respond. I am also grateful that in at least two of their letters they demonstrated clearly that they grasped the two main points of the editorial: (1) that physicians should not think of instructions written in charts or transmitted to other health professionals as "orders" they themselves are giving but rather as instructions transmitted on behalf of the patient, and (2) that even when thought of as instructions from the patient, the term "order" is excessively harsh.

Dr Grattan's formulation seems to me to be essentially correct. Patients should formulate treatment plans for such crucial decisions as cardiopulmonary resuscitation and other forms of resuscitation, taking into account the recommendations of any persons they trust, including their physician, priest, friends, and family. The physician is the appropriate person . . . [Full Text PDF of this Article]

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