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A survey of operating room personnel attitudes toward patients in the operating room with a DNR order
Thesis

A survey of operating room personnel attitudes toward patients in the operating room with a DNR order

Steven Frantz
Master of Science (M.S.), Medical College of Pennsylvania
Mar 1994
DOI:
https://doi.org/10.17918/00009487
pdf
Frantz_Steven_19941.54 MB
PDF Access upon request, Email title, URL, or DOI to archives@drexel.edu

Abstract

Anesthesiology
[From introduction] Patients with "do not resuscitate" (DNR) designations are appearing in the very treatment area for which Cardiopulmonary Resuscitation (CPR) was originally developed, the operating room (Cohen and Cohen, 1991). The DNR order, as outlined by patients or their surrogates, delineates a predetermined level of intervention in the event of a cardiac arrest. While in the operating room (OR), the surgical and anesthesia teams are enjoined to treat patients and any intraoperative problems that may develop. Some common operating room interventions could be considered resuscitation in other settings (Stevens, 1991). Therefore, a conflict between two moral principles is created: To respect and preserve patient autonomy by honoring the durable DNR order or to do good as directed by the principle of beneficence. Paternalistic action, by virtue of experience and training, may lead to intervention, and violate the moral rights of an autonomous individual (Keffer and Keffer, 1992). The performance of surgery or delivery of anesthesia without the ability to intervene in the event a problem arises may be incongruent with care (unless the patient accepts the responsibility as with the DNR). It must be noted, however, some physicians feel allowing a peaceful death without maximal intervention is entirely consistent with the role of the physician (Younger, Cascorbi, & Shuck, 1991).

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