May 1990

Do Not Resuscitate Orders

Author Affiliations

London, England

Arch Intern Med. 1990;150(5):1125. doi:10.1001/archinte.1990.00390170147039

To the Editor.—We were interested in Bartholome's1 recent editorial on do not resuscitate (DNR) orders, and the problems associated with their use in the United States. In the United Kingdom, arrangements for deciding resuscitation status are much less formal and the legally binding DNR order does not exist. Resuscitation decisions are often taken by relatively junior medical staff and, in our experience, rarely discussed with either the patients or their relatives. Furthermore, communication of DNR decisions to nursing staff and discussion surrounding the reasons for reaching these decisions may be inadequate.

Many nursing staff in the United Kingdom still seem to regard a DNR decision as having implications for other treatment decisions, so we set up a small study to investigate this. Seventy-five fully trained nurses working in our District General Hospital completed a questionnaire. All nurses worked with acutely ill medical patients admitted from the community via

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