The 1988 DNR Reforms: A Comparative Study of the Impact of the New York DNR Law and the Jcaho Accreditation Requirements
The DNR reforms of 1988, a coincident trial of both the legislative and the self-regulatory routes to reform, provide an ideal vehicle for assessing the impact of bioethical reform. They can be construed as inadvertant “natural experiment,” a comparative trial of the effects of reforming DNR practices by means of an amendment to the state’s public health law, or by means of a change in the accreditation policies of the Joint Commission on Accreditation of Health-Care Organizations (hereafter, JCAHO). In the study described below, we attempt to assess the impact of these two different routes to mandatory bioethical reform: the JCAHO’s latitudinarian professional self-regulative approach; and New York’s use of a statute enforced by the state department of health and the law courts.
KeywordsMedical Director Nursing Director Persistent Vegetative State Terminal Patient Medical Futility
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