Do-not-resuscitate orders. Time for reappraisal in long-term-care institutions

JAMA. 1988 Oct 14;260(14):2098-101. doi: 10.1001/jama.260.14.2098.


KIE: Murphy, a physician, proposes a policy under which the attending physician and nurses would consider the resuscitation status of patients after their admission to a long-term-care (LTC) facility and make unilateral decisions about writing do-not-resuscitate (DNR) orders for severely demented patients and for chronically ill patients for whom CPR is believed to be futile. He reasons that the ethical consensus that patient autonomy should prevail in DNR determinations does not apply to the LTC population where medical indications should be given first priority in ethical decision making. Murphy notes that the broad spectrum of cases adjudicated show that, with few exceptions, courts usually rule that withholding or withdrawing therapy in these instances is legally acceptable.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Aged
  • Beneficence
  • Ethics, Medical
  • Euthanasia*
  • Euthanasia, Passive*
  • Humans
  • Jurisprudence
  • Long-Term Care
  • Paternalism
  • Patient Care Team
  • Patient Participation
  • Patient Selection
  • Personal Autonomy
  • Physician's Role
  • Resource Allocation
  • Resuscitation*
  • Risk Assessment
  • Withholding Treatment