Do Not Resuscitate (DNR) Order
Do-not-resuscitate (DNR) order (Salem Health: Cancer)
Purpose: The purpose of the order is to allow a cancer patient to experience a natural death while under the care of medical personnel. The order is enacted only when the patient stops breathing or the heart stops beating because of the terminal illness. Even with a DNR, a natural death may not be allowed if heart or respiratory failure is caused by an unrelated event such as a car accident. Health care professionals providing care to patients without DNR orders, regardless of the severity of disease, are legally required to provide cardiopulmonary resuscitation (CPR) and perform medical interventions at the time of death. These efforts must not only be initiated but also be continued until they are deemed futile by the physician or a designated professional.
The extraordinary measures performed by health care professionals in the event of respiratory or heart failure include CPR and placing the patient on life support. These procedures are invasive and often considered painful. Appropriately performed CPR can cause broken bones and punctured organs even in generally healthy individuals, such as accident victims. Such injuries are more likely to occur in frail individuals who are near death. Life support may consist of intravenous (IV) drugs that cause the heart to continue to beat. Without the medications, the heart will stop and death will be irreversible in a few minutes, even with aggressive treatment. Mechanical...
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For Further Information (Salem Health: Cancer)
Gott, Peter H. Live Longer, Live Better: Taking Care of Your Health After Fifty. Sanger, Calif.: Quill Driver Books, 2004.
Kiernan, Stephen P. Last Rights: Rescuing the End of Life from the Medical System. New York: St. Martin’s Press, 2006.
Mayo Clinic. Mayo Clinic Family Health Book. 3d ed. New York: HarperCollins, 2003.
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Other Resources (Salem Health: Cancer)
Do Not Resuscitate (DNR) Order (Encyclopedia of Surgery)
Do not resuscitate (DNR) order is a part of advanced medical directives allowed by federal law passed in 1991, expanding the notion of patient autonomy to situations in which they may not be able to make crucial medical decisions due to incapacitation. It instructs medical personnel not to perform life-saving cardiopulmonary resuscitation (CPR) or other procedures to restart the heart or breathing once they have ceased. By law, the DNR directive must be offered as an option to patients by health providers in, and in some states, out of a hospital setting. Once signed, the DNR directive must be placed in the in the patient's chart.
With such advanced cardiopulmonary techniques as CPR, it is possible to keep almost any patient's heart and lungs functioning, independent of how terminal or hopeless their medical condition becomes. The DNR program is designed to help people in the final stages of a terminal illness or who have intractable pain the option for deciding against life-saving measures that may only prolong their pain and death. The option of deciding against life-saving measures is considered to be a formal part of patient autonomy and is respected as an ethical subset of medical informed consent.
(The entire section is 946 words.)