CPR for the DNR: The Role of the Limited Aggressive Therapy Order

Annals of Internal Medicine, Vol. 138, pp. 65-68, 2003

Posted: 14 Sep 2017

See all articles by Sujit Choudhry

Sujit Choudhry

Center for Global Constitutionalism, WZB Berlin Social Science Center

Date Written: 2003

Abstract

Patients who sustain a cardiac arrest have a less than 20% chance of surviving to hospital discharge. Patients may request do-not resuscitate (DNR) orders if they believe that their chances for a meaningful recovery after cardiopulmonary arrest are low. However, in some identifiable circumstances, cardiopulmonary resuscitation (CPR) has a higher chance of success and lower likelihood of neurologic impairment. The probability of survival from a cardiac arrest influences patients’ wishes regarding resuscitation; thus, when CPR has a higher likelihood of success, patients’ expressed preferences for treatment as contained within a DNR order may not accurately reflect their intended goals. Patients should be offered the option of consenting to CPR for “higher success” situations, including a witnessed cardiopulmonary arrest in which the initial cardiac rhythm is ventricular tachycardia or fibrillation, cardiac arrest in the operating room, and cardiac arrest resulting from a readily identifiable iatrogenic cause. This new level of resuscitation could be called a “limited aggressive therapy” order.

Suggested Citation

Choudhry, Sujit, CPR for the DNR: The Role of the Limited Aggressive Therapy Order (2003). Annals of Internal Medicine, Vol. 138, pp. 65-68, 2003. Available at SSRN: https://ssrn.com/abstract=3026215

Sujit Choudhry (Contact Author)

Center for Global Constitutionalism, WZB Berlin Social Science Center ( email )

Reichpietschufer 50
D-10785 Berlin, 10785
Germany

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