open access

Vol 18, No 1 (2013)
SpeciaI issue papers
Published online: 2013-01-01
Submitted: 2012-02-04
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Physician perspectives on resuscitation status and DNR order in elderly cancer patients

Sachin Trivedi
DOI: 10.1016/j.rpor.2012.12.002
·
Rep Pract Oncol Radiother 2013;18(1):53-56.

open access

Vol 18, No 1 (2013)
SpeciaI issue papers
Published online: 2013-01-01
Submitted: 2012-02-04

Abstract

Aim

To evaluate the process of placing DNR order in elderly cancer patients in practice and analysis of physician perspectives on the issue.

Background

Decision not to resuscitate (DNR/DNAR) is part of practice in elderly cancer care. Physicians issue such orders when a patient is suffering from irreversible disease and the patient's life is coming to an end. Modern practice emphasises the need of communication with the patients and their relatives while issuing a DNR. The decision making process of placing DNR can be quite daunting. The moral and ethical dimensions surrounding such a decision make it a contentious topic.

Materials and methods

We searched the literature to find relevant works that would help physicians and especially the junior health care staff in dealing with the complexities. In this article, we discuss the issues that physicians encounter whilst dealing with a DNR order in elderly cancer patients.

Results

There are no objective adjuncts or guidelines directed towards the approach of placing a DNR in elderly cancer patients. Better communication with the patients and relatives when making such decision remains a very important aspect of a DNR decision. Most health care staff find themselves ill equipped to deal with such situation. Active training and briefing of junior staff would help them deal better with the stresses involved in this process.

Conclusion

There are complex psychosocial, medical, ethical and emotive aspects associated with placing a DNR order. Patients and their loved ones and the junior staff involved in the care of patient need early communication and briefing for better acceptance of DNR. Studies that could devise or identify tools or recommendations would be welcome.

Abstract

Aim

To evaluate the process of placing DNR order in elderly cancer patients in practice and analysis of physician perspectives on the issue.

Background

Decision not to resuscitate (DNR/DNAR) is part of practice in elderly cancer care. Physicians issue such orders when a patient is suffering from irreversible disease and the patient's life is coming to an end. Modern practice emphasises the need of communication with the patients and their relatives while issuing a DNR. The decision making process of placing DNR can be quite daunting. The moral and ethical dimensions surrounding such a decision make it a contentious topic.

Materials and methods

We searched the literature to find relevant works that would help physicians and especially the junior health care staff in dealing with the complexities. In this article, we discuss the issues that physicians encounter whilst dealing with a DNR order in elderly cancer patients.

Results

There are no objective adjuncts or guidelines directed towards the approach of placing a DNR in elderly cancer patients. Better communication with the patients and relatives when making such decision remains a very important aspect of a DNR decision. Most health care staff find themselves ill equipped to deal with such situation. Active training and briefing of junior staff would help them deal better with the stresses involved in this process.

Conclusion

There are complex psychosocial, medical, ethical and emotive aspects associated with placing a DNR order. Patients and their loved ones and the junior staff involved in the care of patient need early communication and briefing for better acceptance of DNR. Studies that could devise or identify tools or recommendations would be welcome.

Get Citation

Keywords

Cancer in the elderly; Resuscitation; DNR; Advanced directives

About this article
Title

Physician perspectives on resuscitation status and DNR order in elderly cancer patients

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 18, No 1 (2013)

Pages

53-56

Published online

2013-01-01

DOI

10.1016/j.rpor.2012.12.002

Bibliographic record

Rep Pract Oncol Radiother 2013;18(1):53-56.

Keywords

Cancer in the elderly
Resuscitation
DNR
Advanced directives

Authors

Sachin Trivedi

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