Association between religious and socio-economic background of parents of children with solid tumors and DNR orders.
BACKGROUND
The influence of socio-economic and religious background on decisions made by parents of children with incurable cancer regarding DNR orders is not fully understood.


METHODS
A retrospective analysis of medical charts of patients who died between January 2000 and January 2011 was performed. The following data were sought: written evidence of DNR discussion with parents, religious background, educational level, monthly income.


RESULTS
There was evidence of a discussion on DNR in 73/90 charts. DNR consent was obtained in 14/17 (82.4%) cases where at least one parent had >15 years of education versus in only 24/45 (53.3%) cases where both parents had ≤15 years education as determined by univariate analysis (P = 0.03). DNR consent was also more likely to be obtained among parents of children with income >10,000 NIS (24/30, 80.0% vs. 20/38, 52.6%, P = 0.013). Parents of Jewish (22/30, 73.3%), Islamic (16/26, 61.5%), and Christian (8/9, 88.9%) background were equally likely to provide DNR consent. However, Druze families were less likely to do so (2/8, 25.0%, P = 0.036).


CONCLUSIONS
The process of decision-making to a DNR request was associated with parents' educational level and monthly family income, and not by religious background, with the exception of Druze families.
Department of Pediatric Oncology/Hematology, Meyer Children's Hospital, Rambam Health Care Campus, and Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
Inbal
I
Hileli
Myriam
M
Weyl Ben Arush
Fahed
F
Hakim
Sergey
S
Postovsky
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003657:Decision Making; D004493:Education; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D008499:Medical Records; D009369:Neoplasms / Q000401:mortality* / Q000523:psychology*; D010290:Parents / Q000523:psychology*; D011379:Prognosis; D012067:Religion; D016414:Resuscitation Orders / Q000523:psychology*; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D015996:Survival Rate; D055815:Young Adult
cancer; child; death; do not resuscitate; parent; religion; socio-economic status