期刊论文详细信息
Clinical Medicine Insights: Circulatory, Respiratory and Pulmonary Medicine
The DNR Order: What Does it Mean?
Review
John Y.C. Tsang Md1 
[1] Division of Critical Care Medicine, Department of Medicine, University of British Columbia, Vancouver, Canada.;
关键词: cardiopulmonary disease;    critical care;    end of life issues;    epidemiology trends;    ethics;    health care policy;    level of care;    public health economics;   
DOI  :  10.1177/117954842020100401
来源: Sage Journals
PDF
【 摘 要 】

As medical science continues to advance, patients nowadays with progressive cardiopulmonary diseases live to older ages. However, they too will eventually reach their unsustainable physiological limit and many die in poor health and discomfort prior to their demise. Regrettably many physicians have not kept pace in dealing with the inevitable end-of- life issues, along with modern technological developments. Without proper guidance, ill-informed patients often face unnecessary anxiety, receive futile resuscitation at the expense of their dignity and public cost which has and will become increasingly overwhelming according to our current demographic trends. In any health care reform, experts often suggest that difficult questions will have to be asked but the solutions are at least partly in the logistical details. From time to time, we see an isolated “Do Not Resuscitate” or DNR order in the chart, which is not always followed by thoughtful discussion on the boundary of care, either simultaneously or known to be followed up soon. This paper attempts to begin asking some of these difficult questions, point out the fallacies of this order and expose the weaknesses in the present state of entitlement by public demand if physicians retreats more from the discussion. The solution does not lie in asking the questions but in changing the practice pattern in real life on a continuous basis, hopefully to be eventually accepted by most, if not all.

【 授权许可】

CC BY-NC   
© 2010 SAGE Publications.

【 预 览 】
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RO202212207183956ZK.pdf 603KB PDF download
Table 4. 753KB Table download
Table 6 43KB Table download
Figure 4. 1130KB Image download
Table 8 59KB Table download
Figure 3. 60KB Image download
Table 2. 514KB Table download
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