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KMID : 1025620030060010015
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Korean Journal of Medical Ethics
2003 Volume.6 No. 1 p.15 ~ p.33
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A Survey on the Medical Doctor’s Concept on DNR (Do-Not-Resuscitate) Order
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Han Sung-Suk
Han Mi-Hyun
Yong Jin-Sun
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Abstract
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The study was intended to identify the doctor’s experiences, understanding, and attitudes on DNR . Also, the study was to provide the data base for a standard of DNR decision-making and practice. The sample consisted of 96 doctors in two general hospitals. The data were collected between October 1 and December 15, 2002. The Data was analyzed using descriptive statistics and χ2 test.
The results of the study were as follows :
1. Regarding DNR-related experience, 69.8 percent of the participants experienced DNR situations. Approximately 18.8 percent the participants received DNR education.
2. The DNR Order was recoded at 66.7% on doctor’s sheet.
3. DNR was most frequently(38.5%) requested by family members and relatives of patients, followed by medical staff(27.1%) and patients themselves with advanced directives(7.3%). The decision-making on DNR was most frequently (56.3%) made by agreement between family members and medical staff, followed by patients themselves(1,0%).
4. Problems after DNR order were negligence in treatment and nursing care(26%), and guilty feelings due to not doing the best(14.6%). CPR(cardiopulmonary resuscitation) was performed about 34.4% of DNR cases.
5. Regarding understanding and attitude on DNR, most of the participants(94.8%) thought DNR was necessary. The major reasons for the necessity of DNR were impossible recovery( 63.5%) and death with dignity(26%).
6. The decision-making on DNR was most frequently made by family members and medical staff(36.5%), followed by patient and family(27.1%), patients themselves(13.5%), conferance of medical staff and chief staff(11.4%) and ethics committee of the hospital(6.3%).
7. Ninety three point eight percent of the participants thought that medical staff must explain DNR to critical and end-of-life patients and their family members. The most appropriate time for DNR explanation was when patients with critical disease were admitted to hospitals(47.9%). Most of the participants(84.4%) thought a guide book for DNR is necessary to be made in hospitals.
8. There were significant differences in the participants experienced on DNR according to age(p<.05).
The findings of the study suggest that a guide book for DNR need to be made with inclusion of legal, ethical, and cultural aspects, Also, there needs to be more education on DNR in medical ethics to helth care professionals and to provide more information on DNR to the general public.
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KEYWORD
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DNR(Do Not Resuscitate), ethical decision-making
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