title: Do-not-resuscitate orders in cancer patients: a review of literature.
abstract: Discussing do-not-resuscitate (DNR) orders is part of daily hospital practice in oncology departments. Several medical factors and patient characteristics are associated with issuing DNR orders in cancer patients. DNR orders are often placed late in the disease process. This may be a cause for disagreements between doctors and between doctors and patients and may cause for unnecessary treatments and admissions. In addition, DNR orders on itself may influence the rest of the medical treatment for patients. We present recommendations for discussing DNR orders and medical futility in practice through shared decision-making. Prospective studies are needed to investigate in which a patient's cardiopulmonary resuscitation (CPR) is futile and whether or not DNR orders influence the medical care of patients.
authors: Department of Internal Medicine, Maxima Medical Centre, De Run 4600, 5504DB, Veldhoven, the Netherlands. aart_osinski@hotmail.com.
authors: Aart
authors: A
authors: Osinski
authors: Department of Internal Medicine, Maxima Medical Centre, De Run 4600, 5504DB, Veldhoven, the Netherlands.|Department of Oncology, Maastricht University Medical Centre +, Maastricht, the Netherlands.
authors: Gerard
authors: G
authors: Vreugdenhil
authors: Department of Intensive Care Medicine, Maxima Medical Centre, De Run 4600, 5504DB, Veldhoven, the Netherlands.
authors: Jan
authors: J
authors: de Koning
authors: Department of Intensive Care Medicine, Radboud University Medical Centre, Geert Grooteplein Zuid 10, 6525, GA, Nijmegen, the Netherlands.
authors: Johannes G
authors: JG
authors: van der Hoeven
mesh_terms: D016887:Cardiopulmonary Resuscitation / Q000941:ethics*; D003657:Decision Making / Q000941:ethics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy; D011446:Prospective Studies; D016414:Resuscitation Orders / Q000941:ethics*
keywords: Cancer; Cardiopulmonary resuscitation; Do-not-resuscitate orders; Medical futility; Neoplasms; Resuscitation orders