The Journal of Emergency Medicine
Volume 33, Issue 3 , Pages 299-305 , October 2007

Does a Living Will Equal a DNR? Are Living Wills Compromising Patient Safety?

  • Ferdinando L. Mirarchi, DO, FAAEM

      Affiliations

    • Corresponding Author InformationReprint Address: Ferdinando L. Mirarchi, do, faaem, Department of Emergency Medicine, Hamot Medical Center, 201 State Street, Erie, PA 16550

Received 3 November 2005 ,Revised 9 August 2006 ,Accepted 16 November 2006.

References 

  1. U.S. Census Bureau. 2004 Population Estimates, Census 2000, 1990 Census. 2005;Available at. http://www.census.gov/. Accessed March
  2. Degenholz HB, Rhee Y, Arnold RM. The relationship between living will and dying in place. Ann Intern Med. 2004;141:113–117
  3. Pa. C.S. Title 20; Chapter 54; Advanced Directives for Health Care, Sections 5401–16.
  4. Bartholome WG. “Do not resuscitate” orders: accepting responsibility. Arch Intern Med. 1988;148:2345–2346
  5. Emergency Cardiac Care Committee and SubcommitteesAmerican Heart Association. Guidelines for cardiopulmonary resuscitation and Emergency Cardiac Care, VIII: ethical considerations in resuscitation. JAMA. 1992;268:2282–2288
  6. Presidents Commission for the study of Ethical Problems in Medicine and Biomedical Research. Deciding to forego life-sustaining treatment: ethical, medical and legal issues in treatment decisions. In: Washington, DC: US Government Printing Office; 1983;p. 231–255
  7. Miles SH, Crawford R, Shultz AL. The do-not-resuscitate order in a teaching hospital. Ann Intern Med. 1982;96:660–664
  8. Standards for cardiopulmonary resuscitation (CPR) and emergency cardiac care (ECC): medico legal considerations and recommendations. JAMA. 1986;255:2979–2984
  9. Henneman EA, Baird B, Bellamy PE, Faber LL, Oye RK. Effect of do-not-resuscitate orders on the nursing care of critically ill patients. Am J Crit Care. 1994;3:467–472
  10. Sherman DA, Branum K. Critical care nurses’ perceptions of appropriate care of the patient with orders not to resuscitate. Heart Lung. 1995;24:321–329
  11. Youngner SJ. Do-not-resuscitate orders: no longer a secret but still a problem. Hastings Cent Rep. 1987;17:24–33
  12. Uhlmann RF, Cassel CK, McDonald WJ. Some treatment-withholding implications of no code orders in academic hospital. Crit Care Med. 1984;12:879–881
  13. La Puma J, Silverstein MD, Stocking CB, Roland D, Seigler M. Life-sustaining treatment (A prospective study of patients with DNR orders in a teaching hospital). Arch Intern Med. 1988;148:2193–2198
  14. Bedell SE, Pelle D, Maher Pl, Cleary PD. Do-not-resuscitate orders for critically ill patients in the hospital (How are they used and what is their impact?). JAMA. 1986;256:233–237
  15. Fragerlin A, Schneider CE. Enough: the failure of the living will. Hastings Cent Rep. 2004;34:30–42
  16. Goodman MD, Tarnoff M, Slotman GJ. Effect of advanced directives on the management of elderly critically ill patients. Crit Care Med. 1998;26:701–704
  17. Beach MC, Morrison RS. The effect of do-not-resuscitate orders on physician decision-making. J Am Geriatr Soc. 2002;50:2057–2061
  18. Bedell SE, Delbanco TL. Choices about cardiopulmonary resuscitation in the hospital (When do physicians talk with patients?). N Engl J Med. 1984;310:1089–1093
  19. Lewandowski W, Daly B, Mclish DK, Juknialis BW, Younger SJ. Treatment and care of “do not resuscitate” patients in a medical intensive care unit. Heart Lung. 1985;14:175–181
  20. Thibault-Prevost J, Jensen LA, Hodgins M. Critical nurses’ perception of DNR status. J Nurs Scholarsh. 2000;259–265
  21. Hewitt WJ, Marco CA. DNR. does it mean “do not treat”?. ACEP News. 2004;3;June
  22. Shelly SI, Zahorchak RM, Gambril CDS. Aggressiveness of nursing care for older patients and those with do-not-resuscitate orders. Nurs Res. 1987;36:157–162
  23. Tulsky JA, Fisher GS, Rose MR, Arnold RM. Opening the black box: how do physicians communicate about advanced directives?. Ann Intern Med. 1998;129:441–449
  24. Larson DG, Tobin DR. End-of-life conversations evolving practice and theory. JAMA. 2000;284:1573–1578
  25. Morrison MF. Obstacles to doctor-patient communication at the end of life. In:  Steinberg MD,  Youngner SJ editor. End-of-life decisions: a psychosocial perspective. Washington, DC: American Psychiatric Press; 1998;p. 109–136

PII: S0736-4679(07)00161-8

doi: 10.1016/j.jemermed.2007.02.026

The Journal of Emergency Medicine
Volume 33, Issue 3 , Pages 299-305 , October 2007