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Allow-Natural-Death (AND) Orders: Legal, Ethical, and Practical Considerations

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Abstract

Conversations with patients and families about the allow-natural-death (AND) order, along with the standard do-not-resuscitate (DNR) order during end-of-life (EOL) decision-making, may create engagement and understanding while promoting care that can be defended using enduring notions of autonomy, beneficence, and professional duty. Ethical, legal, and pragmatic issues surrounding EOL care decision-making seem to suggest discussion of AND orders as one strategy clinicians could consider at the individual practice level and at institutional levels. A discussion of AND orders, along with traditional DNR orders is presented. This is followed by argument and counter-argument focused on ethical, legal, and practical issues germane to EOL care decision-making associated with use of AND orders.

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Authors and Affiliations

  1. Valdosta State University, 1300 North Patterson St., Valdosta, GA, 31698, USA

    Maura C. Schlairet

  2. Ethics Department, Wellstar Health System, 805 Sandy Plains Rd., Marietta, GA, 30066, USA

    Richard W. Cohen

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  1. Maura C. Schlairet
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  2. Richard W. Cohen
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Correspondence to Maura C. Schlairet.

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Schlairet, M.C., Cohen, R.W. Allow-Natural-Death (AND) Orders: Legal, Ethical, and Practical Considerations. HEC Forum 25, 161–171 (2013). https://doi.org/10.1007/s10730-012-9181-1

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