Do-not-resuscitate orders in suicidal patients: clinical, ethical, and legal dilemmas.
BACKGROUND
The authors review the literature related to patients who obtain a Do-Not-Resuscitate (DNR) order in preparation for a suicide attempt.


OBJECTIVE
The authors review the ethical issues involved in making a decision to resuscitate or not in an attempted suicide with a DNR order.


METHODS
The authors address the potential legal consequences of action or inaction and clinical issues to consider before a DNR order is issued.


RESULTS
DNR laws do not take into account the situation of the mentally ill person framing a DNR order as a preparation for suicide.


CONCLUSIONS
The article recommends screening for suicidal ideation before issuing DNR orders, having clear hospital policies regarding the honoring of DNR orders if suicide is attempted, and clarification of state DNR laws regarding suicide.
Cook
Renee
R
Southern Illinois University School of Medicine, Dept. of Psychiatry, P.O. Box 19642, Springfield, IL 62794-9642, USA.
Pan
Philip
P
Silverman
Ross
R
Soltys
Stephen M
SM
D006801:Humans; D001523:Mental Disorders; D016414:Resuscitation Orders / Q000941:ethics* / Q000331:legislation & jurisprudence*; D013405:Suicide / Q000941:ethics* / Q000331:legislation & jurisprudence*; D014481:United States