Should patient consent be required to write a do not resuscitate order?
Consent ought to be required to withhold treatment that is in a patient's best interests to receive. Do not resuscitate (DNR) orders are examples of best interests assessments at the end of life. Such assessments represent value judgments that cannot be validly ascertained without patient input. If patient input results in that patient dissenting to the DNR order then individual physicians are not justified in overriding such dissent. To do so would give unjustifiable primacy to the values of the individual physician. Therefore patient consent is effectively required to write a DNR order. Patient dissent to a DNR order should trigger a fair process mechanism to resolve the dispute.
Biegler
P
P
Emergenvy Department, Sandringham Hospital, 193 Bluff Road, Sandringham, Victoria 3191, Australia. pbiegler@bigpond.net.au
D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D006801:Humans; D007258:Informed Consent / Q000941:ethics*; D007600:Judgment; D008297:Male; D026684:Personal Autonomy; D010817:Physician-Patient Relations; D016414:Resuscitation Orders / Q000941:ethics*; D012941:Social Responsibility; D019452:Terminally Ill; D028761:Withholding Treatment / Q000941:ethics