Involving Patients in Do Not Resuscitate (DNR) Decisions: An Old Issue Raising Its Ugly Head
Loewy, Erich H.
Journal of Medical Ethics. 1991 Sep; 17(3): 156-160.
A recent paper in this journal suggests that involving terminally ill patients in choices concerned with Cardio-Pulmonary Resucitation (CPR) produces "psychological pain" and therefore is ill-advised. Such a claim rests on anecdotal observations made by the authors. In this paper I suggest that drawing conclusions in ethics, no less than in science, requires a rigorous framework and cannot be relegated to personal observation of a few cases. The paper concludes by suggesting that patients, if we acknowledge their valid interest in making their own choices, must themselves be allowed to make a prior choice about choosing. Those who may not wish to choose may properly be relieved of this burden and may allow another to choose for them. Routinely allowing others to make choices for competent adults, however, is likely to decrease communication with the dying patient and to introduce an atmosphere of suspicion and fear and to exclude the competent patient from his/her rightful place in the community.
Adults; Communication; Competence; Consent; Decision Making; Disclosure; Ethics; Family Members; Pain; Paternalism; Patient Participation; Patients; Physicians; Prognosis; Psychological Stress; Resuscitation; Resuscitation Orders; Risks and Benefits; Science; Terminal Care; Terminally Ill; Truth Disclosure; Values;
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Loewy, Erich H. (1991-09)