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Do Not Resuscitate Orders: Ethical Considerations

A Do Not Resuscitate Order may be classified as a form of euthanasia. To be more particular, it is considered as passive euthanasia and thus, there are ethical concerns associated with it although not as much as other forms of euthanasia. A Do Not Resuscitate Order is however accepted in the society since there are medical situations that would deem a no resuscitate order unnecessary since it will no longer help cure the patient and will only result in additional and unnecessary suffering.

Cardiopulmonary resuscitation, otherwise known as CPR, is a medical procedure that would re-establish blood circulation and respiration. Hospitals usually have a policy that would state when CPR can be withheld. Such instances are when the CPR would prove to have no medical benefit which is also referred to as “medical futility” and when the patient indicates he/she does not want CPR when the need arises. This would mean that the patient has already accepted his/her inevitable death. In medical cases that still have hope, a Do Not Resuscitate Order should not be warranted (Braddock, 2008).

An ethical dilemma also arises when the patient can no longer decide for himself and someone else decides on a Do Not Resuscitate Order. This is a major point of debate when talking of euthanasia since other people should be allowed to decide for the lives of other people since it may be against the best interest of the ailing. In the absence of an order, medical practitioners have the sworn duty to perform CPR to resuscitate a dying patient (Braddock, 2008). CPR may be deemed futile if it offers no clinical benefit.

In such a case, a physician may make a sound judgment to withhold resuscitation since it is ethically justified. The meaning of “be of benefit” must however be identified and such could be measured by knowing the success rate of performing CPR on certain situations. CPR has a zero percent success rate in septic shock, acute stroke, metastatic cancer and severe pneumonia. It also showed very low success rates for hypotension at 2 percent, renal failure at 3 percent, AIDS at 2 percent, homebound lifestyle at 4 percent, and ages greater than 70 at 4 percent (Braddock, 2008).

In some cases when the resuscitation may be successful for patients in a vegetative state, it is still considered futile since the patient will still be in a vegetative state even after resuscitation. In some cases, even if CPR is successful, it may be useless in a sense that the patient will still die because of other reasons which could be severe hemorrhage, etc. (Braddock, 2008). In cases when the patient request a Do Not Resuscitate Order even if it would help him recover, the doctors respect the request since it is passive euthanasia and not active euthanasia which is illegal.

In other cases when the patient cannot say what his decision is, an advance directive is often used or having a surrogate decision maker (Braddock, 2008). A Do Not Resuscitate Order conforms with ethical standards and despite its being classified as a form of euthanasia which associates it to controversy. It is still within moral grounds since it is classified as a form of euthanasia which is not banned by law.

References

Braddock III, Clarence H. 11 April 2008. Ethics in Medicine: Do Not Resuscitate Orders. University of Washington School of Medicine. Retrieved July 25, 2008, from http://depts. washington. edu/bioethx/topics/dnr. html

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