Do-not-resuscitation in Terminal Cancer Patient.
10.14475/kjhpc.2015.18.3.179
- Author:
Jung Hye KWON
1
Author Information
1. Division of Hematology-Oncology, Department of Internal Medicine, Hallym University College of Medicine, Seoul, Korea. Kwonjhye@naver.com
- Publication Type:Review
- Keywords:
Resuscitation orders;
Right to die;
Terminal care;
Neoplasms
- MeSH:
Cardiopulmonary Resuscitation;
Decision Making;
Emigrants and Immigrants;
Heart, Artificial;
Humans;
Jurisprudence;
Korea;
Medical Futility;
Palliative Care;
Quality of Life;
Respiratory System;
Resuscitation Orders;
Right to Die;
Survival Rate;
Terminal Care;
Thorax;
Ventilation
- From:Korean Journal of Hospice and Palliative Care
2015;18(3):179-187
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
For patients who are near the end of life, an inevitable step is discussion of a do-not-resuscitate (DNR) order, which involves patients, their family members and physicians. To discuss DNR orders, patients and family members should know the meaning of the order and cardiopulmonary resuscitation (CPR) which includes chest compression, defibrillation, medication to restart the heart, artificial ventilation, and tube insertion in the respiratory tract. And the following issues should be considered as well: patients' and their families' autonomy, futility of treatment, and the right for death with dignity. Terminal cancer patients should be informed of what futility of treatment is, such as a low survival rate of CPR, unacceptable quality of life after CPR, and an irremediable disease status. In Korea, two different law suits related to life supporting treatments had been filed, which in turn raised public interest in death with dignity. Since the 1980s, knowledge of and attitude toward DNR among physicians and the public have been improved. However, most patients are still alienated from the decision making process, and the decision is often made less than a week before death. Thus, the DNR discussion process should be improved. Early palliative care should be adopted more widely.
