Patients' attitudes towards "do not attempt resuscitation" status

Area of Science:

• Medical Ethics
• Patient Autonomy
• Critical Care Medicine

Background:

• Do not attempt resuscitation (DNAR) decisions are typically made during critical illness when patients cannot provide informed consent.
• Current guidelines exist, but patient perspectives on discussing DNAR are under-researched.

Purpose of the Study:

• To investigate patient attitudes towards discussing DNAR decisions before they become critically ill.
• To understand patient preferences regarding the timing and involvement of relatives in DNAR discussions.

Main Methods:

• A prospective study was conducted in a general outpatient department.
• Consecutive outpatients received a questionnaire with an explanatory leaflet.
• 364 patients completed the questionnaire, yielding a 77% response rate.

Main Results:

• 90% of respondents desired patients to be asked about DNAR decisions during hospitalization.
• 37% preferred discussing DNAR on admission, 32% in outpatient settings.
• 87% accepted relative involvement, though only 12% had prior experience discussing a relative's status.

Conclusions:

• Contrary to current practice, most patients wish to discuss DNAR status proactively, even if initially uncomfortable.
• Patient preferences indicate a need for more accessible documentation of DNAR decisions.
• While open to family involvement, some patients prefer their relatives not be consulted.