Document Detail

Legitimating do-not-resuscitate orders: a discursive study of cancer patients' speech.
MedLine Citation:
PMID:  12955926     Owner:  NLM     Status:  MEDLINE    
This article examines how patients with cancer construct and legitimate do-not-resuscitate (DNR) orders. Semi-structured interviews with 23 outpatients attending an oncology clinic were tape-recorded, transcribed, and analyzed in accordance with discourse-analytic methodology. Results indicate some variability for participants regarding the meaning of DNR orders, which were nonetheless viewed as appropriate and desirable. The patient's subsequent death was legitimated primarily through the invocation of highly valorized discourses within Western society: nature, autonomy, and compassion. Non-compliance with DNR orders, or the instigation of CPR was seen as violating nature, infringing autonomy, and as uncompassionate. The combined effect was to construct dying as a natural event which is the concern of the individual patient and their family, endorsing medical non-intervention in the process. This research provides support, from the patients' viewpoint, for a policy of non-intervention when death is imminent and inevitable, and for those questioning the wisdom of a default policy of initiating CPR on any hospitalized patient, especially those patients inevitably in the process of dying.
Jaklin A Eliott; Ian N Olver
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of palliative care     Volume:  19     ISSN:  0825-8597     ISO Abbreviation:  J Palliat Care     Publication Date:  2003  
Date Detail:
Created Date:  2003-09-05     Completed Date:  2003-11-07     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8610345     Medline TA:  J Palliat Care     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  100-6     Citation Subset:  E; IM    
Royal Adelaide Hospital Cancer Research Centre, Royal Adelaide Hospital, Adelaide, Australia.
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MeSH Terms
Attitude to Death*
Decision Making
Interview, Psychological
Neoplasms / psychology*,  therapy
Patients / psychology*
Resuscitation Orders / psychology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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