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https://hdl.handle.net/2440/51860
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Type: | Journal article |
Title: | The perceptions of do-not-resuscitate policies of dying patients with cancer |
Author: | Olver, I. Eliott, J. |
Citation: | Psycho-Oncology: journal of the psychological, social and behavioral dimensions of cancer, 2008; 17(4):347-353 |
Publisher: | John Wiley & Sons Ltd |
Issue Date: | 2008 |
ISSN: | 1057-9249 1099-1611 |
Statement of Responsibility: | Ian Olver and Jaklin A. Eliott |
Abstract: | Patients in hospitals must authorize do-not-resuscitate (DNR) orders or the default cardiopulmonary resuscitation (CPR) occurs. Using discursive analysis, we examined the speech of 28 cancer patients, judged as within 3 months of death, to determine how they justified preferences for DNR orders. Most saw these as a positive outcome of not interfering with a natural death with the decision being personal and the legal right of a competent autonomous person. If surrogates were required, they needed knowledge of the medical facts and the patient's wishes. The doctor was crucial, while family although likely to be supportive may be burdened by the responsibility. Some favored an early DNR discussion, but the majority favored a later discussion when it was applicable. At interview, 58% patients had a DNR order, rising to 82% by the time of death. Written orders were favored, yet 9 of 21 who did not want CPR had no DNR order. Hope was mentioned spontaneously by 25 patients, both as a thing over which patients had little control and as the desire of a positive future outcome. If doctors' and patients' assessments of eligibility for DNR orders do not coincide, the process and documentation of decision-making needs revision. |
Keywords: | Humans Neoplasms Complementary Therapies Cardiopulmonary Resuscitation Resuscitation Orders Terminal Care Euthanasia Health Knowledge, Attitudes, Practice Motivation Individuality Family Sick Role Physician-Patient Relations Decision Making Interview, Psychological Cost of Illness Adult Aged Middle Aged Patient Participation Female Male |
Description: | The definitive version may be found at www.wiley.com |
DOI: | 10.1002/pon.1246 |
Published version: | http://dx.doi.org/10.1002/pon.1246 |
Appears in Collections: | Aurora harvest Psychology publications |
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