Dnr Ethical Dilemmas

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The patient’s right to refuse or terminate medical treatment came about in 1976 and lead to the common medical use of the do not resuscitate (DNR) order (Geppert, 2010). In 1990, the patient Self-Determination Act required hospitals to uphold a patient’s right to make personal health care choices and determined that a patient could refuse any medical treatment, including resuscitative measures (Geppert, 2010). The DNR order is usually issued within a hospital setting as a doctor’s order, to eliminate unwanted medical resuscitative measures for patients who frequently have an underlying fatal illness or disease, and wish to decline resuscitative emergency care (Sine, 2010). Every state has statutory requirements in place that recognize the autonomy …show more content…
In the article, “Do-Not-Resuscitate Orders in Suicidal Patients: Clinical, Ethical, and Legal Dilemmas”, the authors discuss the literature related to patients who obtain a DNR order in preparation for a suicide attempt (Cook, Pan, Silverman & Soltys, 2010). When suicidal patients with DNR orders take action to kill themselves, it creates dire situations for nurses and other associated healthcare workers. An example cited in the article explains how the patient, Ms. A, was discovered in her room with constricted pupils and shallow breathing following an overdose. She had a funeral home card on her body, was holding a rosary in her hands, and a copy of the DNR order from her physician (Cook et al., 2010). An evaluation of the scene and the items with the patient gave the immediate impression that she had planned this and was attempting suicide. The code team was placed in a difficult situation because the patient had a DNR order but the doctor was ordering them to revive the patient. The code team revived her based on the attending psychiatrist’s orders and later confirmed that it was indeed a suicide attempt (Cook et al., 2010). After an ethics committee met to review the elements of the situation, Ms. A’s request for a reinstatement of the DNR order was denied on the grounds that she was not terminally ill and she had a prior history of suicide attempts (Cook et al., 2010). This type of behavior raises many questions about how to provide nursing care for those who simply want to