Family Consent to Orders Not to Resuscitate: Reconsidering Hospital Policy
Hackler, J. Chris
Hiller, F. Charles
JAMA. 1990 Sep 12; 264(10): 1281-1283.
The authors call for reform of hospital policies that now require family permission before a do-not-resuscitate (DNR) order may be written for patients who are not competent to give consent themselves. Hackler and Hiller report two cases where the lives and suffering of dying patients were prolonged when family members insisted upon cardiopulmonary resuscitation (CPR) despite hopeless prognoses. They argue that the authority of family members to make treatment decisions is limited when neither patients' preferences nor best interests are served. They propose that hospital policies concerning resuscitation be changed so that: 1) the option of futile resuscitation need not be offered to patients or family members, and 2) family agreement to CPR need not be obtained in every case where the procedure is not clearly futile. (KIE abstract)
Adults; Case Studies; Communication; Consent; Decision Making; Disclosure; Dying Patients; Family Members; Futility; Hospitals; Hospital Policies; Informed Consent; Institutional Policies; Life; Minors; Parents; Patients; Physicians; Prognosis; Prolongation of Life; Psychological Stress; Resuscitation; Resuscitation Orders; Risks and Benefits; Standards; Suffering; Terminally Ill; Third Party Consent;
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