title: The "do-not-resuscitate" order in palliative surgery: Ethical issues and a review on policy in Hong Kong.
abstract: A do-not-resuscitate (DNR) order, or "advance directive," is commonly seen in the cases of palliative patients who express a wish to withhold specific resuscitative therapies in the event of a cardiac arrest. With recent technological advances, there are increasing numbers of palliative patients who undergo surgical interventions to treat their symptoms and discomfort. The decision to suspend DNR orders for palliative surgery is always a matter for debate. The present article describes a case and the ethical issues involved and gives some practical suggestions for those facing similar problems. We also review the latest DNR policy in Hong Kong.
authors.affiliation: Department of Clinical Oncology,Queen Mary Hospital,Hong Kong.
authors.forename: Wing Lok
authors.initials: WL
authors.lastname: Chan
mesh_terms: D001859:Bone Neoplasms / Q000150:complications / Q000556:secondary / Q000601:surgery*; D002292:Carcinoma, Renal Cell / Q000473:pathology; D006291:Health Policy; D006323:Heart Arrest / Q000209:etiology / Q000628:therapy*; D006723:Hong Kong; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology; D008175:Lung Neoplasms / Q000556:secondary; D008297:Male; D008875:Middle Aged; D059408:Pain Management / Q000379:methods; D010166:Palliative Care / Q000941:ethics* / Q000379:methods; D019990:Perioperative Care / Q000009:adverse effects / Q000941:ethics*; D026684:Personal Autonomy; D011788:Quality of Life; D016414:Resuscitation Orders / Q000941:ethics*
keywords: Anesthesiology; Cardiopulmonary resuscitation; Do not resuscitate; Ethics; Palliative care; Surgery