Does the New York State DNR Law Prevent Medically Inappropriate DNR?
The designers of New York State’s Do-Not-Resuscitate (DNR) law endeavored, among other things, to create a means of preventing medically inappropriate resuscitation — that is, resuscitation that “will probably fail or succeed only to the extent that the patient is repeatedly resuscitated in a short time period before death” (, pp. 6–8). The word “fail” is not further defined, but the law permits the physician to make the decision to withhold CPR in cases of “medical futility,” which is defined as a situation in which CPR would be “unsuccessful in restoring cardiac and respiratory function” or that the patient would “experience repeated arrest in a short time period before death occurs” (, §2970). To this end, the law would provide immunity to doctors who wrote DNR orders in good faith, and means would be devised to overrule families who insisted on resuscitation that would clearly be medically futile. Although it is doubtful that regulations mandated and delineated by state law have any advantages over existing practices , another, and possibly primary purpose of the law was to prevent covert DNR orders. To this end, the law would require a process whereby consent not to resuscitate would have to be obtained from the patient or surrogate in all but a few, highly exceptional circumstances.
KeywordsHepatic Encephalopathy Cardiopulmonary Resuscitation Medical Futility General Medical Patient Chronic Medical Disease
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