To the Editor.
—While encouraging flexibility in DNR policies for the OR, both the article by Walker1 and the accompanying editorial by Youngner et al2 failed to mention an important aspect of such policies—the patient's option to have life support discontinued when it is acknowledged to be death-delaying rather than life-prolonging. Our experience suggests that most terminally ill patients request DNR orders not out of a desire to die, but because they do not want to be kept alive on life support with little or no hope of recovery. In this respect, we believe that few patients with DNR orders who consent to operative procedures expect to die as a result of their surgery.In recognition of this, as part of the preoperative informed consent process, patients should be given the option to have intubation and/or vasopressors instituted when needed during surgery with the guarantee that they will
Franklin C, Rothenberg DM. DNR in the OR. JAMA. 1992;267(11):1465-1466. doi:10.1001/jama.1992.03480110041017