Do Not Resuscitate Orders: Key Ethical Issues

EthicsLab

As patients, surrogate decision makers, and clinicians discuss goals of care, questions arise regarding what interventions will physiologically work and what interventions will honor the patient’s values. Do Not Resuscitate Orders are one of the interventions frequently discussed. Our lead contributor on this episode, Mark Repenshek, Executive Director for Ethics & Mission at Hospital Sisters Health System, in Wisconsin is in conversation with guests to explore a number of ethical issues related to Do Not Resuscitate orders that include, but are not limited to: a) Patient/Surrogate desires for full resuscitation despite the intervention’s lack of efficacy in specific clinical circumstances, b) Consideration of partial codes as a “compromise” co-status, c) A physicians’ professional right to limit the use of resuscitation efforts in certain circumstances. The episode also introduces a new series within the EthicsLab Podcast called EthicsLab Essentials. This new series is designed to be an introductory series of modules to enrich ethics committee members. Our guests in this episode are: Dr. Jacqueline K. Yuen, MD, geriatrician, palliative care physician and medical educator. Dr. Yuen is now Assistant Clinical Professor, Department of Medicine at the University of Hong Kong Dr. Michael Ruben, M.D., M.A., neurointensivist and clinical ethicist Dr. Gregory Holt, M.D., Ph.D., pulmonary critical care physician at the University of Miami and VA Medical Center in Miami