With increasing client control of decisions at the end stage of terminal illnesses, new issues have arisen for both doctors and nurses. One of those issues involves the "do not resuscitate" order which patients may establish during the end stage process. At the same time, those same patients, or their doctors, may wish to institute surgical procedures for pain relief or symptom management. There is a clear conflict here, since each time an individual undergoes surgical procedures under general anesthetic, there are risks that they will not return to natural breathing through natural processes. Thus, the institution, and individual health care providers involved, place themselves at-risk of lawsuits if they ignore, or follow, the "do not resuscitate" order in this instance. There are other issues involved, including the use of health care resources, but the basic question to be explore in this paper is whether or not patients with such an order should be permitted to undergo surgical procedures with the order still in effect.
The first step here is to clarify what the "do not resuscitate" order means. It means that if the patient's heart stops, there will be no efforts to revive that patient. The patient will simply be allowed to die naturally, with no medical intervention.
The Royal College of Nursing, along with other professional organizations, noted that these orders are important documents that should only be considered after discussion with the patient and family members or others close to the patient (Ebrahim, 2000). "Do not resuscitate" orders, in other words, do not always originate with the patient, but may be determined by health care providers. This is dangerous, however, and may lead to lawsuits, complaints, and in appropriate medical decisions on behalf of patients who cannot complain or advocate for themselves. Even though resuscitation is ineffective in the vast majority of cases, it should remain an o...