Current Status of Do-not-resuscitate Discussions for Terminal Cancer Patients in Japan

Yosuke Matsuda; Sachiko Ohde; Masanori Mori; Isseki Maeda; Takashi Yamaguchi; Hiroto Ishiki; Yutaka Hatano; Jun Hamano; Tatsuya Morita

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Current Status of Do-not-resuscitate Discussions for Terminal Cancer Patients in Japan

VernacularTitle:終末期がん患者の心肺蘇生をしないことに関する話し合いの現状
Author: Yosuke MATSUDA ¹ ; Sachiko OHDE ² ; Masanori MORI ³ ; Isseki MAEDA ⁴ ; Takashi YAMAGUCHI ⁵ ; Hiroto ISHIKI ⁶ ; Yutaka HATANO ⁷ ; Jun HAMANO ⁸ ; Tatsuya MORITA ³
Author Information

1. Department of Palliative Care, Tokyo Kyosai Hospital
2. Graduate School of Public Health, St. Luke's International University
3. Department of Palliative and Supportive Care, Seirei Mikatahara General Hospital
4. Department of Palliative Care, Senri-Chuo Hospital
5. Department of Palliative Medicine, Kobe University School of Medicine
6. Department of Palliative Medicine, National Cancer Center Hospital
7. Department of Palliative Care, Daini Kyoritsu Hospital
8. Faculty of Medicine, University of Tsukuba
Keywords: do-not-resuscitate discussions; end-of-life discussions; cardiopulmonary resuscitation; terminal cancer; bereaved families
From:Palliative Care Research 2024;19(2):137-147
CountryJapan
Language:Japanese
Abstract: Purpose: The purpose of this study was to clarify the current status of Do-Not-Resuscitate discussions (DNRd) with terminally ill cancer patients in Japan and the psychological burden on bereaved families depending on whether or not a DNRd is performed. Method: A multicenter prospective observational study of advanced cancer patients admitted to 23 palliative care units (PCUs) in Japan was conducted, and a questionnaire survey of bereaved families was also conducted after patients died. Result: 1,605 patients were included in the analysis, and 71.4% of patients had a DNRd with doctors before PCU admission, 10.8% at admission, and 11.4% during admission. In contrast, 93.3% of family members had a DNRd with doctors before PCU admission, 48.4% at admission, and 52.1% during admission. Conclusion: Although DNRd was performed between patients and physicians in 72.3% of cases at any point throughout the course of time from before PCU admission to death, there was no evidence of psychological burden such as depression or complicated grief in the bereaved families due to patient participation in DNRd.