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New Do-Not-Resuscitate Policies

New Do-Not-Resuscitate Policies Abstract The article by Murphy and Finucane on new do-not-resuscitate (DNR) policies1 leaves the reader perplexed. First, the policies are not new; second, the rationale for the new policies is contradicted by the authors themselves and the data available in the literature. The new DNR policies the authors propose are really a new procedure for development of DNR policies. The idea is that community members along with hospital officials, professional groups, and governmental groups propose new DNR policies for the hospitals of a city. This community-based development of hospital policies is hardly a novel idea. Oregon health decisions began developing what they called "informed community consent" on the whole range of terminating care issues.2 Similarly, for years, Emanuel3 has advocated community-based decision-making not just for terminating care but also for allocating scarce medical resources. In his book,4 he has elaborated the theoretical justification for such community-based policy References 1. Murphy DJ, Finucane TE. New do-not-resuscitate policies: a first step in cost control . Arch Intern Med. 1993;153:1641-1648.Crossref 2. Crawshaw R, Garland MJ, Hines B, Lobitz C. Oregon health decisions: an experiment with informed community consent . JAMA . 1985;254:3212-3216.Crossref 3. Emanuel EJ. A communal vision of care for incompetent patients . Hastings Cent Rep. 1987;17:15-20.Crossref 4. Emanuel EJ. The Ends of Human Life: Medical Ethics in a Liberal Polity . Cambridge, Mass: Harvard University Press; 1991; chap 5-6 . 5. Vitelli CE, Cooper K, Rogatko A, Brennan MF. Cardiopulmonary resuscitation and the patient with cancer . J Clin Oncol. 1991;9:111-115. 6. Smedira NG, Evans BH, Grais LS, et al. Withholding and withdrawal of life support from the critically ill . N Engl J Med. 1990;322:309-315.Crossref 7. Gleeson K, Wise S. The do-not-resuscitate order: still too little too late? Arch Intern Med. 1990;150:1057-1060.Crossref 8. Schwartz WB. The inevitable failure of current cost containment strategies . JAMA. 1987;257:220-224.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

New Do-Not-Resuscitate Policies

Archives of Internal Medicine , Volume 154 (13) – Jul 11, 1994

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Publisher
American Medical Association
Copyright
Copyright © 1994 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1994.00420130134018
Publisher site
See Article on Publisher Site

Abstract

Abstract The article by Murphy and Finucane on new do-not-resuscitate (DNR) policies1 leaves the reader perplexed. First, the policies are not new; second, the rationale for the new policies is contradicted by the authors themselves and the data available in the literature. The new DNR policies the authors propose are really a new procedure for development of DNR policies. The idea is that community members along with hospital officials, professional groups, and governmental groups propose new DNR policies for the hospitals of a city. This community-based development of hospital policies is hardly a novel idea. Oregon health decisions began developing what they called "informed community consent" on the whole range of terminating care issues.2 Similarly, for years, Emanuel3 has advocated community-based decision-making not just for terminating care but also for allocating scarce medical resources. In his book,4 he has elaborated the theoretical justification for such community-based policy References 1. Murphy DJ, Finucane TE. New do-not-resuscitate policies: a first step in cost control . Arch Intern Med. 1993;153:1641-1648.Crossref 2. Crawshaw R, Garland MJ, Hines B, Lobitz C. Oregon health decisions: an experiment with informed community consent . JAMA . 1985;254:3212-3216.Crossref 3. Emanuel EJ. A communal vision of care for incompetent patients . Hastings Cent Rep. 1987;17:15-20.Crossref 4. Emanuel EJ. The Ends of Human Life: Medical Ethics in a Liberal Polity . Cambridge, Mass: Harvard University Press; 1991; chap 5-6 . 5. Vitelli CE, Cooper K, Rogatko A, Brennan MF. Cardiopulmonary resuscitation and the patient with cancer . J Clin Oncol. 1991;9:111-115. 6. Smedira NG, Evans BH, Grais LS, et al. Withholding and withdrawal of life support from the critically ill . N Engl J Med. 1990;322:309-315.Crossref 7. Gleeson K, Wise S. The do-not-resuscitate order: still too little too late? Arch Intern Med. 1990;150:1057-1060.Crossref 8. Schwartz WB. The inevitable failure of current cost containment strategies . JAMA. 1987;257:220-224.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Jul 11, 1994

References