Use of the Concept Do Not Resuscitate (DNR)

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Many advances in medicine have resulted in an increase in recoverability from previously believed unrescuable conditions, most notably cardiopulmonary resuscitation (CPR). This particular advance in death mitigation has evolved over time and resulted in previously unforeseen conversations with patients and their families regarding specifying level of resuscitative efforts in the face of death. Do not resuscitate (DNR) orders, one of the outcomes of successful and ubiquitously implemented CPR, can be found throughout healthcare agencies in several countries. Laws regarding its implementation vary by country, state and setting. Despite its long history of use in healthcare, confusion regarding the topic remains among both clinicians and patients and their families. Part of the misinterpretation can be attributed to the enormous ethical implications regarding ability to rescue versus appropriateness of rescue in individual patients. To alleviate this ethical concern, CPR as rescue has been established as the standard of care throughout healthcare agencies and in the community at large with the advent of prehospital care in the form of emergency medical technicians (EMT) as well as community level basic life support (BLS) training. The purpose of this paper is to explore the concept of DNR, including pure definition of the terms and understanding the evolution of DNR in end of life terminology as well as how the term DNR affects patient outcome in an attempt to clarify meaning. DNR as a concept will be analyzed using the method proposed by Walker and Avant (2010). The paper will first identify all uses of the concept. It will also determine defining attributes of the concept to include related concepts. This paper will high... ... middle of paper ... ...itutional-law-keyed-to-stone/implied-fundamental-rights/cruzan-v-director-missouri-department-of-health-2/2/ Definition of resuscitate. (n.d.). Retrieved December 4, 2013, Merriam Webster online dictionary Web site: http://www.merriam-webster.com/dictionary/resuscitate Do not resuscitate. (2013, November 19). Retrieved December 4, 2013, from wikipedia.com: http://en.wikipedia.org/wiki/Do_not_resuscitate Kehl, K. A. (2006). Moving toward peach: An analysis of the concept of a good death. American Journal of Hospice and Palliative Care, 23(4), 277-286. Sanderson, A., Zurakowski, D., & Wolfe, J. (2013). Clinician perspectives regarding the do-not-resuscitate order. Journal of American Medical Association Pediatrics, 167(10), 954-958. Walker, L. O., & Avant, K. C. (2010). Strategies for Theory Construction in Nursing (5th ed.). Upper Saddle River, NJ: Prentice Hall.

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