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Appropriate use of DNR orders: a practical approach
1Department of Bioethics, Cleveland Clinic, USA. agichg@ccf.org
Cleveland Clinic Journal of Medicine
|June 22, 2000
Summary
Physicians can improve end-of-life care by enhancing communication and understanding surrounding cardiopulmonary resuscitation (CPR) effectiveness. This approach aids in resolving conflicts and reaching consensus on treatment decisions, respecting legal and ethical boundaries.
Area of Science:
- Medical Ethics
- Palliative Care
- Clinical Communication
Background:
- End-of-life care decisions are frequently complicated by poor physician-patient communication.
- Misunderstandings regarding the effectiveness of cardiopulmonary resuscitation (CPR) impact decision-making.
- Lack of consensus hinders optimal patient care at the end of life.
Purpose of the Study:
- To present a structured approach for resolving conflicts in end-of-life care.
- To facilitate consensus-building between physicians, patients, and families.
- To support physician judgment in withholding futile treatments.
Main Methods:
- Describing a communication and decision-making framework.
- Integrating legal and ethical considerations (patient autonomy).
- Focusing on physician judgment regarding treatment futility.
Main Results:
- The described approach facilitates conflict resolution.
- Consensus on end-of-life care can be achieved more effectively.
- Physician judgment is supported in withholding non-beneficial interventions.
Conclusions:
- Improved communication is crucial for effective end-of-life care.
- A structured approach can enhance decision-making and consensus.
- Balancing futility, law, and autonomy is key in end-of-life care discussions.
Keywords:
Death and Euthanasia