In their article, Boyd et al1 suggest that "older patients are significantly more likely than younger patients to have do-not-resuscitate (DNR) orders written," and conclude that this association represents "age discrimination" against older patients. However, in their letter, Rosenfeld and Wenger2 state that a "higher rate of DNR orders represents provider responsiveness to elderly patients' own values and preferences." We recently carried out a small study in our hospital—a community teaching hospital—to address this issue. Our data strongly suggest that the patient's preference, rather than age discrimination, is a decisive factor in obtaining DNR orders for elderly patients admitted to intensive care units (ICUs).
Cao L, Song W. Do-Not-Resuscitate Orders in Critical Care Elderly: No Age Discrimination Against Elderly in a Community Hospital. Arch Intern Med. 1998;158(10):1154. doi:
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