Do not resuscitate decisions: discussions with patients

Area of Science:

• Medical Ethics
• Patient Communication
• Clinical Psychology

Background:

• Discussing do not resuscitate (DNR) status can cause significant psychological distress in patients.
• Existing medical practice often mandates full disclosure of DNR status.

Observation:

• Case histories reveal patients experiencing distress when informed of their DNR status.
• Patient reactions to initial information vary, indicating a need for tailored communication.

Findings:

• Not all patients require immediate or full disclosure of their DNR status.
• Incremental information delivery, guided by patient response, is a proposed approach.
• Physician's duty includes assessing patient willingness to discuss DNR status.

Implications:

• This approach may mitigate psychological harm associated with DNR discussions.
• It emphasizes patient-centered communication in end-of-life care decisions.
• Revises the physician's duty from mandatory disclosure to assessing patient readiness.