To the Editor.—
An order stating that a patient should not be resuscitated ("do not resuscitate," or DNR) means that in the event of cardiac or respiratory arrest, life-restoring efforts will be withheld. Confusion exists concerning inferences from such an order. A recent issue of JAMA contains a report regarding DNR orders1 similar to an article published a year earlier.2 Although the format of the investigation is similar, some of the results and many of the conclusions differ markedly. Some of the differences are disturbing.Youngner et al2 emphasize that the "DNR order does not mean that patients will be medically or emotionally abandoned." By contrast, Zimmerman et al1 feel that "avoiding treatment that would not positively affect the patient's condition" is ethically implied by the DNR order. Both cite findings from their studies supporting these radically different ethical interpretations of the DNR order.As stated by
Elliott BA, Day TW. 'Do Not Resuscitate' Orders. JAMA. 1986;255(22):3114. doi:10.1001/jama.1986.03370220076014
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