Korean J Hosp Palliat Care.  2015 Sep;18(3):179-187. 10.14475/kjhpc.2015.18.3.179.

Do-not-resuscitation in Terminal Cancer Patient

Affiliations
  • 1Division of Hematology-Oncology, Department of Internal Medicine, Hallym University College of Medicine, Seoul, Korea. Kwonjhye@naver.com

Abstract

For patients who are near the end of life, an inevitable step is discussion of a do-not-resuscitate (DNR) order, which involves patients, their family members and physicians. To discuss DNR orders, patients and family members should know the meaning of the order and cardiopulmonary resuscitation (CPR) which includes chest compression, defibrillation, medication to restart the heart, artificial ventilation, and tube insertion in the respiratory tract. And the following issues should be considered as well: patients' and their families' autonomy, futility of treatment, and the right for death with dignity. Terminal cancer patients should be informed of what futility of treatment is, such as a low survival rate of CPR, unacceptable quality of life after CPR, and an irremediable disease status. In Korea, two different law suits related to life supporting treatments had been filed, which in turn raised public interest in death with dignity. Since the 1980s, knowledge of and attitude toward DNR among physicians and the public have been improved. However, most patients are still alienated from the decision making process, and the decision is often made less than a week before death. Thus, the DNR discussion process should be improved. Early palliative care should be adopted more widely.

Keyword

Resuscitation orders; Right to die; Terminal care; Neoplasms

MeSH Terms

Cardiopulmonary Resuscitation
Decision Making
Emigrants and Immigrants
Heart, Artificial
Humans
Jurisprudence
Korea
Medical Futility
Palliative Care
Quality of Life
Respiratory System
Resuscitation Orders
Right to Die
Survival Rate
Terminal Care
Thorax
Ventilation
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