Abstract
The do-not-resuscitate order, introduced nearly a half century ago, continues to raise
questions and controversy among health care providers and patients. In today's society,
the expectation and availability of medical interventions, including at the end of
life, have rendered the do-not-resuscitate order particularly relevant. The do-not-resuscitate
order is the only order that requires patient consent to prevent a medical procedure
from being performed; therefore, informed code status discussions between physicians
and patients are especially important. Epidemiologic studies have informed our understanding
of resuscitation outcomes; however, patient, provider, and institutional characteristics
account for great variability in the prevalence of do-not-resuscitate orders. Specific
strategies can improve the quality of code status conversations and enhance end-of-life
care planning. In this article, we review the history, epidemiology, and determinants
of do-not-resuscitate orders, as well as frequently encountered questions and recommended
strategies for discussing this important topic with patients.
Keywords
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Article info
Footnotes
Funding: None.
Conflict of Interest: None of the authors have any conflicts of interest associated with the work presented in this manuscript.
Authorship: All authors had access to the data and played a role in writing this manuscript.
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© 2010 Published by Elsevier Inc.
