Discharge Patterns, Survival Outcomes, and Changes in Clinical Management of Hospitalized Adult Patients with Cancer with a Do-Not-Resuscitate Order

Azad, Arun; Siow, Sue-Faye; Tafreshi, Ali; Moran, Juli; Franco, Michael

doi:10.1089/jpm.2013.0554

Cited by 18 publications

(20 citation statements)

References 17 publications

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“…[14–16] A DNR order can also be written to avoid futile treatment and resuscitation while continuing appropriate symptom-attenuated treatment. [17,18] The “right to die” was first discussed in an American study by Rabkin et al [19] in 1976. New York was the first state to approve DNR orders in 1988.…”

Section: Introductionmentioning

confidence: 99%

The do-not-resuscitate order for terminal cancer patients in mainland China

Huang¹,

Chen

Wang

et al. 2018

Medicine

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With the development of palliative care, a signed do-not-resuscitate (DNR) order has become increasingly popular worldwide. However, there is no legal guarantee of a signed DNR order for patients with cancer in mainland China. This study aimed to estimate the status of DNR order signing before patient death in the cancer center of a large tertiary affiliated teaching hospital in western China. Patient demographics and disease-related characteristics were also analyzed.This was a retrospective chart analysis. We screened all charts from a large-scale tertiary teaching hospital in China for patients who died of cancer from January 2010 to February 2015. Analysis included a total of 365 records. The details of DNR order forms, patient demographics, and disease-related characteristics were recorded.The DNR order signing rate was 80%. Only 2 patients signed the DNR order themselves, while the majority of DNR orders were signed by patients' surrogates. The median time for signing the DNR order was 1 day before the patients' death. Most DNR decisions were made within the last 3 days before death. The time at which DNR orders were signed was related to disease severity and the rate of disease progression.Our findings indicate that signing a DNR order for patients with terminal cancer has become common in mainland China in recent years. Decisions about a DNR order are usually made by patients' surrogates when patients are severely ill. Palliative care in mainland China still needs to be improved.

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Section: Introductionmentioning

confidence: 99%

The do-not-resuscitate order for terminal cancer patients in mainland China

Huang¹,

Chen

Wang

et al. 2018

Medicine

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“…A correct understanding of DNR orders is also important. Patients with DNR orders should not be deprived of appropriate palliative care when necessary [13].…”

Section: Introductionmentioning

confidence: 99%

Do-not-resuscitate orders among advanced-stage Chinese lung cancer patients who died in hospital

Wang

Zhao

et al. 2015

Support Care Cancer

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The DNR order-signing rate has been increasing annually among terminal patients with lung cancer in China. DNR orders, all of which were signed by surrogates, were more likely to be accepted by patients with slowly deteriorating disease and longer OS. More effort should be taken to help patients and medical professionals establish a sensible understanding of EOL care, including DNR orders, at earlier points during the disease course.

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“…As a result, formidable efforts have been achieved to raise applying the DNR code in patients with terminal cancer in order to avoid unnecessary and distressing resuscitation [22].…”

Section: Legal Aspectmentioning

confidence: 99%

Do Not Resuscitate Expressly Allowed Natural Death: A Common Ethical Dilemma Among Terminally Ill Cancer Patients

Salim¹,

Nematollahi²,

Nigim³

et al. 2017

Nurs Palliat Care

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Background: Every human being desires a life without suffering and to live his or her life in best possible quality of life, but when death is looming by a terminal disease and one is lying in bed with machines to maintain organ functions; there comes the dilemma of the choice. However, patients may place healthcare providers at prospect of ethical dilemma by declining to care or to provide treatment, despite that patients have the right to do so.

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Discharge Patterns, Survival Outcomes, and Changes in Clinical Management of Hospitalized Adult Patients with Cancer with a Do-Not-Resuscitate Order

Cited by 18 publications

References 17 publications

The do-not-resuscitate order for terminal cancer patients in mainland China

The do-not-resuscitate order for terminal cancer patients in mainland China

Do-not-resuscitate orders among advanced-stage Chinese lung cancer patients who died in hospital

Do Not Resuscitate Expressly Allowed Natural Death: A Common Ethical Dilemma Among Terminally Ill Cancer Patients

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