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Finding the right words: using the terms allow natural death (AND) and do not resuscitate (DNR) in pediatric

Barbara L Jones1, Jessica Parker-Raley, Renee Higgerson

  • 1Institute for Grief, Loss and Family Survival, University of Texas-Austin School of Social Work, USA. barbarajones@mail.utexas.edu

Journal for Healthcare Quality : Official Publication of the National Association for Healthcare Quality
|October 4, 2008
PubMed

Insights

Pediatric providers find "allow natural death" (AND) ambiguous but potentially more family-centered than "do not resuscitate" (DNR) when discussing end-of-life care for dying children.

Area of Science:

  • Pediatric healthcare
  • Medical ethics
  • End-of-life care communication

Background:

  • Healthcare providers guide families through critical end-of-life decisions for children.
  • Standard terminology like "do not resuscitate" (DNR) is often used.
  • Alternative terms, such as "allow natural death" (AND), are also employed.

Purpose of the Study:

  • To investigate pediatric healthcare providers' perceptions of using "allow natural death" (AND) versus "do not resuscitate" (DNR).
  • To understand provider beliefs regarding the suitability of AND in pediatric end-of-life discussions.

Main Methods:

  • Survey or interview-based study with pediatric healthcare providers.
  • Exploration of provider attitudes towards AND and DNR terminology.
  • Analysis of perceived clarity and family-centeredness of each term.

Main Results:

  • Providers perceive "allow natural death" (AND) as somewhat ambiguous.
  • Healthcare providers believe AND may be a more family-centered approach compared to DNR.
  • The study highlights nuances in communication preferences for pediatric palliative care.

Conclusions:

  • The choice of terminology in end-of-life care discussions significantly impacts family perception.
  • Further research is needed to optimize communication strategies for pediatric palliative care.
  • AND may offer a more compassionate alternative to DNR, despite its ambiguity.

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