Abstract

KIE: Murphy, a physician, proposes a policy under which the attending physician and nurses would consider the resuscitation status of patients after their admission to a long-term-care (LTC) facility and make unilateral decisions about writing do-not-resuscitate (DNR) orders for severely demented patients and for chronically ill patients for whom CPR is believed to be futile. He reasons that the ethical consensus that patient autonomy should prevail in DNR determinations does not apply to the LTC population where medical indications should be given first priority in ethical decision making. Murphy notes that the broad spectrum of cases adjudicated show that, with few exceptions, courts usually rule that withholding or withdrawing therapy in these instances is legally acceptable.