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Do-not-resuscitate orders for terminal patients with cancer in teaching hospitals of Korea

Title
Do-not-resuscitate orders for terminal patients with cancer in teaching hospitals of Korea
Authors
Kim D.Y.Lee K.E.Nam E.M.Lee H.R.Lee K.-W.Kim J.H.Lee J.S.Lee S.N.
Ewha Authors
이순남이경은남은미
SCOPUS Author ID
이순남scopus; 이경은scopus; 남은미scopus
Issue Date
2007
Journal Title
Journal of Palliative Medicine
ISSN
1096-6218JCR Link
Citation
vol. 10, no. 5, pp. 1153 - 1158
Indexed
SCIE; SCOPUS WOS scopus
Abstract
Objectives: To examine the current practices relating to do-not-resuscitate (DNR) orders for terminal patients with cancer at teaching hospitals in Korea. Methods: The records of 387 deaths from January 1 to December 31, 2005 at four cancer centers were identified and reviewed to assess the DNR delineation. Basic demographics, circumstances surrounding the establishment of the DNR directive, the percentage of orders for identified populations, and the time interval between DNR consent and death were evaluated. Results: An order of DNR consent was obtained from 296 patients (76%) of a total of 387 patients. All DNR consents were made between the physician and family, without involving the patient. Written preprinted DNR consent forms were used in 169 (57%) cases and 127 patients (43%) had verbal DNR permission. DNR consent was interpreted in two ways: one forbade resuscitation in two hospitals and the other implied limited care in two other hospitals. A unilateral physician decision to withhold cardiopulmonary resuscitation (CPR) was decided for 62 (16%) patients. Terminal CPR was performed on 29 (7%) patients. DNR discussion was made within 7 days of the day of death on 228 (77%) patient among the 296 DNR consenting patients. Conclusion: From our teaching-hospital-based analysis of terminal cancer patients in Korea, consent for a DNR order was common. However, DNR order forms were not standardized and lacked room to document patient involvement in the decision. Usually the DNR decision was made within last days of the patient's life. Our results reflect the need for the improvement of end-of-life care decisions in Korea. © 2007 Mary Ann Liebert, Inc.
DOI
10.1089/jpm.2006.0264
Appears in Collections:
의학전문대학원 > 의학과 > Journal papers
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