Ethics and Communication in Do-Not-Resuscitate Orders

Despite the extensive literature devoted to do-not-resuscitate (DNR) orders, they continue to raise vexing problems for physicians, house staff, nurses, and policy makers. The difficulties include physicians' ambivalence about who should be consulted before a DNR order is written, the frustration of house officers and nurses who are asked to continue complicated or invasive treatments of a patient for whom a DNR order has been written, and hospital administrators' uncertainty and confusion over what their DNR policies should be. Many of these problems arise from the failure to distinguish among three distinct rationales for DNR orders and to appreciate their.