title: Easing the burden of surrogate decision making: the role of a do-not-escalate-treatment order.
abstract: We present a case illustrating the common problem of a surrogate decision maker who is psychologically distressed over the medical team's recommendation to withdraw life-sustaining treatment. We suggest how a do-not-escalate-treatment (DNET) order can be helpful in such situations when the usual approaches to withholding or withdrawing care are not acceptable to the surrogate. We define a DNET order, explain when it might be useful, and discuss how it can facilitate a humane, negotiated resolution of differences.
authors: 1 Palliative Care Division, Massachusetts General Hospital , Boston, Massachusetts.
authors: Juliet
authors: J
authors: Jacobsen
authors: Andrew
authors: A
authors: Billings
mesh_terms: D017028:Caregivers / Q000523:psychology*; D003657:Decision Making; D005260:Female; D006801:Humans; D008080:Liposarcoma / Q000451:nursing*; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000523:psychology*; D016414:Resuscitation Orders / Q000523:psychology*; D013315:Stress, Psychological / Q000517:prevention & control; D020458:Third-Party Consent; D014481:United States; D028761:Withholding Treatment