title: CPR in New Zealand hospitals: an alternate perspective on lawfulness and ways to improve practice.
abstract: The current approach to CPR in New Zealand hospitals is that it is attempted on all patients in cardiac arrest unless a DNR order is in place. Concern has been raised that this approach results in some "unlawful" CPR on the grounds that it is not in the patient's best interests. It has been suggested that policy change is required and one suggestion is a move away from DNR orders to mandatory "For CPR" orders. Ensuring lawfulness of CPR and more importantly quality care for patients is however more likely to be achieved not by policy change but by improved understanding by doctors and patients of the nature of these decisions, and by training programmes and work environments which value and facilitate difficult conversations, mutually respectful relationships and shared decisions.
authors.affiliation: Medical Law and Ethics, University of Otago, Christchurch, PO Box 4345, Christchurch 8140, New Zealand. maryleigh.moore@otago.ac.nz
authors.forename: MaryLeigh
authors.initials: M
authors.lastname: Moore
authors.forename: Kate
authors.initials: K
authors.lastname: Grundy
mesh_terms: D016887:Cardiopulmonary Resuscitation / Q000941:ethics*; D005260:Female; D018166:Health Care Reform / Q000331:legislation & jurisprudence; D006761:Hospitals / Q000941:ethics* / Q000639:trends; D006801:Humans; D008297:Male; D009520:New Zealand; D011050:Policy Making; D010818:Practice Patterns, Physicians' / Q000941:ethics / Q000331:legislation & jurisprudence; D058996:Quality Improvement; D016414:Resuscitation Orders / Q000941:ethics / Q000331:legislation & jurisprudence*