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‘Do not attempt cardiopulmonary resuscitation’ or ‘allowing natural death’? The time for resuscitation community to review its boundaries and its terminology

  • Theodoros Xanthos
    Correspondence
    Correspondence to: 89 Patision Street, 10434, Athens, Greece.
    Affiliations
    University of Athens, Medical School, MSc program “Cardiopulmonary Resuscitation”, Greece

    Hellenic Society of Cardiopulmonary Resuscitation, Greece
    Search for articles by this author
      The term “do not attempt cardiopulmonary resuscitation” (DNACPR) replaced in the United Kingdom (UK) the older term “do not attempt resuscitation” (DNAR). The terminology changed, at least in the UK, due to misconception of what DNAR really is, as resuscitation is not necessarily only cardiopulmonary resuscitation (CPR). As a result several articles which appeared in the literature defined that DNACPR clearly suggests that CPR should not be started in case of cardiac arrest, but this does not mean the withholding of any other treatment.
      • Bishop J.P.
      • Brothers K.B.
      • Perry J.E.
      • Ahmad A.
      Reviving the conversation around CPR/DNR.
      Despite the many legislative variations around the world regarding the possibility of withholding a potentially beneficial procedure such as CPR, many different countries have embraced different realities. There are countries that allow DNACPR and countries where withholding CPR is a criminal offense.
      • Baskett P.J.
      • Lim A.
      The varying ethical attitudes towards resuscitation in Europe.
      For these countries that DNACPR is an option, the decision may lay with the team of healthcare providers or with the patient's wishes (advanced directives).
      • Schlairet M.C.
      • Cohen R.W.
      Allow-natural-death (AND) orders: legal, ethical, and practical considerations.
      • Bailey F.A.
      • Allen R.S.
      • Williams B.R.
      • et al.
      Do-not resuscitate orders in the last days of life.
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      References

        • Bishop J.P.
        • Brothers K.B.
        • Perry J.E.
        • Ahmad A.
        Reviving the conversation around CPR/DNR.
        Am J Bioeth. 2010; 10: 61-67
        • Baskett P.J.
        • Lim A.
        The varying ethical attitudes towards resuscitation in Europe.
        Resuscitation. 2004; 62: 267-273
        • Schlairet M.C.
        • Cohen R.W.
        Allow-natural-death (AND) orders: legal, ethical, and practical considerations.
        HEC Forum. 2013; 25: 161-171
        • Bailey F.A.
        • Allen R.S.
        • Williams B.R.
        • et al.
        Do-not resuscitate orders in the last days of life.
        J Palliat Med. 2012; 15: 751-759
        • Field R.A.
        • Fritz Z.
        • Baker A.
        • Grove A.
        • Perkins G.D.
        Systematic review of interventions to improve appropriate use and outcomes associated with Do-Not-Attempt-Cardiopulmonary-Resuscitation Orders.
        Resuscitation. 2014;
        • Whitcomb J.J.
        • Ewing N.
        A closing word: do not resuscitate versus allow natural death and should we change our approach.
        Dimens Crit Care Nurs. 2012; 31: 265-266
        • Bishop J.P.
        • Brothers K.B.
        • Perry J.E.
        • Ahmad A.
        Finite knowledge/finite power: death panels and the limits of medicine.
        Am J Bioeth. 2010; 10: W7-W9
        • Cook D.A.
        Narrowing the focus and broadening horizons: complementary roles for nonsystematic and systematic reviews.
        Adv Health Sci Educ Theory Pract. 2008; 13: 391-395
        • Xanthos T.
        • Iacovidou N.
        • Ekmektzoglou K.A.
        From cardiopulmonary to cardiorespiratory resuscitation.
        Resuscitation. 2011; 82: 1360
        • Chliara D.
        • Chalkias A.
        • Horopanitis E.E.
        • Papadimitriou L.
        • Xanthos T.
        Attitude of elderly patients towards cardiopulmonary resuscitation in Greece.
        Geriatr Gerontol Int. 2013; ([Epub ahead of print])https://doi.org/10.1111/ggi.12184
        • Venneman S.S.
        • Narnor-Harris P.
        • Perish M.
        • Hamilton M.
        Allow natural death versus do not resuscitate: three words that can change a life.
        J Med Ethics. 2008; 34: 2-6
        • Jezewski M.A.
        Do-not-resuscitate status: conflict and culture brokering in critical care units.
        Heart Lung. 1994; 23: 458-465
        • Chen Y.Y.
        • Younger S.J.
        “Allow natural death” is not equivalent to “do not resuscitate”: a response.
        J Med Ethics. 2008; 34: 887-888