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Cancers 2016, 8(10), 89; doi:10.3390/cancers8100089

Translating into Practice Cancer Patients’ Views on Do-Not-Resuscitate Decision-Making

1
Sansom Institute, University of South Australia, Adelaide 5000, Australia
2
School of Public Health, University of Adelaide, Adelaide 5000, Australia
*
Author to whom correspondence should be addressed.
Academic Editor: Gregory Crawford
Received: 27 July 2016 / Revised: 8 September 2016 / Accepted: 21 September 2016 / Published: 27 September 2016
(This article belongs to the Special Issue End-of-Life Cancer Care)
View Full-Text   |   Download PDF [182 KB, uploaded 27 September 2016]

Abstract

Do-not-resuscitate (DNR) orders are necessary if resuscitation, the default option in hospitals, should be avoided because a patient is known to be dying and attempted resuscitation would be inappropriate. To avoid inappropriate resuscitation at night, if no DNR order has been recorded, after-hours medical staff are often asked to have a DNR discussion with patients whose condition is deteriorating, but with whom they are unfamiliar. Participants in two qualitative studies of cancer patients’ views on how to present DNR discussions recognized that such patients are at different stages of understanding of their situation and may not be ready for a DNR discussion; therefore, a one-policy-fits-all approach was thought to be inappropriate. To formulate a policy that incorporates the patient’s views, we propose that a standard form which mandates a DNR discussion is replaced by a “blank sheet” with instructions to record the progress of the discussion with the patient, and a medical recommendation for a DNR decision to guide the nursing staff in case of a cardiac arrest. Such an advance care directive would have to honor specifically expressed patient or guardian wishes whilst allowing for flexibility, yet would direct nurses or other staff so that they can avoid inappropriate cardiopulmonary resuscitation of a patient dying of cancer. View Full-Text
Keywords: do-not resuscitate; advance care directive; cancer; DNR policy do-not resuscitate; advance care directive; cancer; DNR policy
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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Olver, I.N.; Eliott, J.A. Translating into Practice Cancer Patients’ Views on Do-Not-Resuscitate Decision-Making. Cancers 2016, 8, 89.

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