Just how far goes DNR?
Mr T. Ragic presented with a thrombosed limb of an aortobifemoral graft placed over 2 decades ago. He has unresectable stage VI lung cancer and do not resuscitate (DNR) orders that were suspended during the thrombectomy. A cardiac arrest resulted in him being in the intensive care unit a day later ventilator-dependent and comatose, and repeated computed tomography scans show severe cerebral edema. He has frequent ventricular dysrhythmias. His eldest daughter is about to deliver his first grandchild, which is the main reason that he requested the procedure to extend his life. In discussions with the family, they express uncertainty about the implications of his DNR order for current treatment. They ask you for your thinking on this matter.
Jones
James W
JW
The Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, Texas, USA. jwjones@bcm.tmc.edu
McCullough
Laurence B
LB
D016887:Cardiopulmonary Resuscitation; D003422:Critical Care / Q000941:ethics*; D006801:Humans; D007258:Informed Consent / Q000941:ethics; D007866:Leg / Q000098:blood supply*; D008175:Lung Neoplasms / Q000150:complications* / Q000523:psychology; D008297:Male; D016414:Resuscitation Orders / Q000941:ethics*; D013927:Thrombosis / Q000150:complications / Q000523:psychology / Q000601:surgery*