Development of a County Pre-Hospital DNR Program: Contributions of a Bioethics Network

Abstract

Do-not-resuscitate (DNR) orders are written by physicians so that cardiopulmonary resuscitation (CPR) is not administered to patients who do not want to be resuscitated should they have a cardiac or pulmonary arrest. DNR orders are appropriate, effective, and common in hospitals: it is difficult to understand why they have largely been excluded from pre-hospital settings. It is also surprising how little effort has been expended to make DNR orders portable between settings and durable in time. We will discuss the development of a pre-hospital DNR program in Orange County, California, with primary emphasis on the supportive role played by the Orange County Bioethics Network (OCBEN).