WHY ARE DNR ORDERS AN ETHICAL ISSUE?

What is a DNR Order?

A Do Not Resuscitate (DNR) order is a medical order that instructs healthcare providers to withhold cardiopulmonary resuscitation (CPR) and other life-sustaining treatments in the event of cardiac or respiratory arrest. DNR orders are typically made by patients or their healthcare proxies when they believe that the burden of aggressive medical interventions outweighs the potential benefits.

Ethical Considerations

DNR orders raise a number of ethical issues, including:

• Respect for Autonomy: The principle of respect for autonomy holds that people have the right to make decisions about their own healthcare, including the decision to refuse treatment. A DNR order is a way for patients to exercise this right.

• Best Interests: The principle of beneficence holds that healthcare providers should act in the best interests of their patients. This can be a difficult standard to apply in the context of DNR orders, as there is often no clear consensus on what is in the patient's best interests.

• Non-Maleficence: The principle of non-maleficence holds that healthcare providers should do no harm to their patients. CPR and other life-sustaining treatments can be harmful, especially if they are performed on patients who are unlikely to benefit from them. A DNR order can be a way to avoid causing unnecessary harm.

• Justice: The principle of justice holds that healthcare should be distributed fairly. Some people argue that DNR orders are unfair because they disproportionately impact the poor and the marginalized, who are less likely to have access to quality healthcare.

Conclusion

The decision of whether or not to issue a DNR order is a complex one that involves a number of ethical considerations. There is no easy answer, and the best decision will vary depending on the specific circumstances of each case.

Frequently Asked Questions

Here are five frequently asked questions about DNR orders:

1. Who can make a DNR order?

A DNR order can be made by the patient themselves, if they are competent to make medical decisions. If the patient is not competent, a healthcare proxy or family member can make the decision on their behalf.

2. What is the difference between a DNR order and a living will?

A DNR order is a medical order that specifically instructs healthcare providers to withhold CPR and other life-sustaining treatments. A living will is a legal document that expresses a person's wishes about end-of-life care more generally.

3. Does a DNR order mean that the patient will not receive any medical care?

No, a DNR order does not mean that the patient will not receive any medical care. Patients with DNR orders can still receive palliative care, pain management, and other treatments that are not intended to prolong life.

4. Can a DNR order be revoked?

Yes, a DNR order can be revoked at any time by the patient or their healthcare proxy.

5. What are the consequences of issuing a DNR order?

Issuing a DNR order can have a number of consequences, including:

• The patient may die sooner than they would if they received CPR or other life-sustaining treatments.
• The patient's family and friends may experience grief and loss.
• The healthcare providers involved in the decision may experience moral distress.