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DNAR: to resuscitate or not to resuscitate, rights, wrongs, ethics and the voice of the patient

DNAR: to resuscitate or not to resuscitate, rights, wrongs, ethics and the voice of the patient
DNAR: to resuscitate or not to resuscitate, rights, wrongs, ethics and the voice of the patient
Do not attempt resuscitation (DNAR) or do not attempt cardiopulmonary resuscitation (DNACPR) orders have been regarded as the best way to ensure that patients are not resuscitated in clinically inappropriate circumstances, or against their wishes. However, the use of DNAR orders has become contentious in situations where individuals have not been informed or consulted before an order is made and recent legal cases have highlighted the need for good communication and record keeping. This paper considers the legal and ethical issues associated with DNAR or DNACPR orders, including the rights of patients, ethical guidance and policies associated with their use, and regional and national variations in practices surrounding their use and implementation. After discussing evidence of misinterpretation and misunderstandings of the implications of such orders in clinical practice, which impact upon patients’ autonomy and well-being, it will conclude that compliance with ethical and professional guidance must be consistent and mandatory, and suggest the introduction of legal sanctions for non-compliance.
Oxford University Press
Biggs, Hazel
d0d08de6-6cae-4679-964c-eac653d7722b
Biggs, Hazel
d0d08de6-6cae-4679-964c-eac653d7722b

Biggs, Hazel (2019) DNAR: to resuscitate or not to resuscitate, rights, wrongs, ethics and the voice of the patient. In, Law and Ethics in Intensive Care 2nd edition. 2 ed. oxford. Oxford University Press. (In Press)

Record type: Book Section

Abstract

Do not attempt resuscitation (DNAR) or do not attempt cardiopulmonary resuscitation (DNACPR) orders have been regarded as the best way to ensure that patients are not resuscitated in clinically inappropriate circumstances, or against their wishes. However, the use of DNAR orders has become contentious in situations where individuals have not been informed or consulted before an order is made and recent legal cases have highlighted the need for good communication and record keeping. This paper considers the legal and ethical issues associated with DNAR or DNACPR orders, including the rights of patients, ethical guidance and policies associated with their use, and regional and national variations in practices surrounding their use and implementation. After discussing evidence of misinterpretation and misunderstandings of the implications of such orders in clinical practice, which impact upon patients’ autonomy and well-being, it will conclude that compliance with ethical and professional guidance must be consistent and mandatory, and suggest the introduction of legal sanctions for non-compliance.

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DNAR - to resuscitate or not to resuscitate FINAL DRAFT[3] - Accepted Manuscript
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Accepted/In Press date: 2019

Identifiers

Local EPrints ID: 428053
URI: http://eprints.soton.ac.uk/id/eprint/428053
PURE UUID: 91db6d80-d58a-4f54-aae9-8284af1ce5a8
ORCID for Hazel Biggs: ORCID iD orcid.org/0000-0002-4434-6543

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Date deposited: 07 Feb 2019 17:30
Last modified: 13 Sep 2024 01:43

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Author: Hazel Biggs ORCID iD

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