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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 J+Palliat+Med
2015 ; 18
(5
): 457-60
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English Wikipedia
"Allow Natural Death" versus "Do Not Resuscitate": What Do Patients with Advanced
Cancer Choose?
#MMPMID25825919
Miljkovi? MD
; Emuron D
; Rhodes L
; Abraham J
; Miller K
J Palliat Med
2015[May]; 18
(5
): 457-60
PMID25825919
show ga
BACKGROUND: Many patients with advanced cancer at our hospital request full
resuscitative efforts at the end of life. We assessed the knowledge and attitudes
of these patients towards end-of-life (EOL) care, and their preferences about "Do
Not Resuscitate" (DNR), "Allow Natural Death" (AND), and "full code" orders.
METHODS: The first 100 consenting adult patients with advanced cancer were
surveyed regarding their diagnosis, prognosis, and attitudes about critical care
and resuscitation. They were then presented with hypothetical scenarios in which
a decision on their code status had to be made if they had one year, six months,
or one month left to live. Half were given a choice between being "full code" and
"DNR," and half could choose between "full code" and "AND." RESULTS: All 93 of
the participants who completed the survey were considered by their attending
physician to have a terminal illness, but only 42% of these interviewees believed
they were terminally ill. In addition, only 25% of participants thought that
their primary oncologist knew their EOL wishes. Participants were equally likely
to choose either of the "no code" options in all hypothetical scenarios (p>0.54),
regardless of age, sex, race, type of cancer, education, or income level. A
similar proportion of patients who had a living will chose "AND" and "DNR" orders
instead of "full code" in all the scenarios (47%-74% and 63%-71%). In contrast,
among patients who did not have a living will, 52% chose "DNR," while 19% opted
for "AND." CONCLUSIONS: We hypothesized that "AND" orders may be more acceptable
to patients with advanced cancer, but there was no statistically significant
difference in acceptability between "AND" and "DNR" orders.
|*Attitude to Death
[MESH]
|*Health Knowledge, Attitudes, Practice
[MESH]
|Adult
[MESH]
|Advance Directives/*psychology/statistics & numerical data
[MESH]
|Aged
[MESH]
|Aged, 80 and over
[MESH]
|Choice Behavior
[MESH]
|Communication
[MESH]
|Female
[MESH]
|Humans
[MESH]
|Interviews as Topic
[MESH]
|Male
[MESH]
|Middle Aged
[MESH]
|Neoplasms/*psychology/therapy
[MESH]
|Patient Preference/psychology/statistics & numerical data
[MESH]
|Resuscitation Orders/*psychology
[MESH]
|Terminal Care/*psychology/standards/statistics & numerical data
[MESH]
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