Younger1 of Case Western Reserve University, Cleveland, entitled a recent review article, "Do-Not-Resuscitate [DNR] Orders: No Longer Secret, but Still a Problem." In this issue of the Archives, Jonsson et al2 describe a retrospective study of DNR orders in a 432-bed university-affiliated teaching community hospital. Their findings document that DNR orders are not only "no longer secret," they have become the norm, at least for this presumably typical tertiary hospital. They report that almost 70% of patients who died in this facility had a written DNR order. The figure for patients with malignancy was even more striking, with 94% having a DNR order at the time of death. They also document that the medical record of over 90% of these patients contained "documentation of the DNR decision-making process."
See also p 2373.
However, Jonsson and coworkers' data also support Younger's observation that there are still serious problems. For
Bartholome WG. 'Do Not Resuscitate' Orders: Accepting Responsibility. Arch Intern Med. 1988;148(11):2345–2346. doi:10.1001/archinte.1988.00380110011003
Coronavirus Resource Center
Customize your JAMA Network experience by selecting one or more topics from the list below.