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Doctors in limbo: the United States ‘DNR’ debate

✍ Scribed by Marguerite S. Lederberg

Publisher
John Wiley and Sons
Year
1997
Tongue
English
Weight
63 KB
Volume
6
Category
Article
ISSN
1057-9249

No coin nor oath required. For personal study only.

✦ Synopsis

Cardiopulmonary resuscitation is unlike any other medical intervention in its emotional impact. Its original use in reversible conditions has been replaced by its expected use in irreversible ones. The history of this transformation and its psychological concommitants are reviewed. New York State is unusual in having a 'DNR' law where resuscitation is the default position unless actively refused by patient or surrogate. The paradoxical genesis of this law, and its complex effect on a tertiary care hospital are described. Attention is focused on the emotional stresses on medical staff, and the extensive teaching program mounted by the institution's ethics committee to enable a positive adaptation. The difficulties inherent in surrogate decision-making are also reviewed.

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