The status of the do-not-resuscitate order in Chinese clinical trial patients in a cancer centre.
OBJECTIVE
To report and analyse the pattern of end-of-life decision making for terminal Chinese cancer patients.


METHODS
Retrospective descriptive study.


METHODS
A cancer clinical trials unit in a large teaching hospital.


METHODS
From April 1992 to August 1997, 177 consecutive deaths of cancer clinical trial patients were studied.


METHODS
Basic demographic data, patient status at the time of signing a DNR consent, or at the moment of returning home to die are documented, and circumstances surrounding these events evaluated.


RESULTS
DNR orders were written for 64.4% of patients. Patients in pain (odds ratio 0.45, 95% CI 0.22-0.89), especially if requiring opioid analgesia (odds ratio 0.40, 95% CI 0.21-0.77), were factors associated with a higher probability of such an order. Thirty-five patients were taken home to die, a more likely occurrence if the patient was over 75 years (odds ratio 0.12, 95% CI 0.04-0.34), had children (odds ratio 0.14, 95% CI 0.02-0.79), had Taiwanese as a first language (odds ratio 6.74, 95% CI 3.04-14.93), or was unable to intake orally (odds ratio 2.73, 95% CI 1.26-5.92). CPR was performed in 30 patients, none survived to discharge.


CONCLUSIONS
DNR orders are instituted in a large proportion of dying Chinese cancer patients in a cancer centre, however, the order is seldom signed by the patient personally. This study also illustrates that as many as 20% of dying patients are taken home to die, in accordance with local custom.
Liu
J M
JM
National Health Research Institutes, Veterans General Hospital, Taipei, Taiwan, Republic of China.
Lin
W C
WC
Chen
Y M
YM
Wu
H W
HW
Yao
N S
NS
Chen
L T
LT
Whang-Peng
J
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002681:China; D003657:Decision Making; D005260:Female; D006699:Home Care Services; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms; D016017:Odds Ratio; D016414:Resuscitation Orders; D012189:Retrospective Studies; D013727:Terminal Care; D036302:Therapeutic Human Experimentation