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. 2020 Apr;151(4):303-310.
doi: 10.4103/ijmr.IJMR_395_20.

ICMR Consensus Guidelines on 'Do Not Attempt Resuscitation'

Roli Mathur  1
Affiliations

ICMR Consensus Guidelines on 'Do Not Attempt Resuscitation'

Roli Mathur. Indian J Med Res. 2020 Apr.

Abstract

Cardiopulmonary resuscitation (CPR) is widely practised by healthcare professionals to revive heart beat and breathing in a patient suffering from cardiac/ respiratory arrest. It is increasingly being recognized that in some patients with specific medical conditions, CPR does not alter the overall outcome of illness, and is likely to increase suffering and further deteriorate the quality of life. Do Not Attempt Resuscitation (DNAR) as an option has been practised in many countries for such cases to avoid futile CPR and maintain dignity of the patient. The decision of DNAR should be taken by the treating physician who is well versed with the patient's medical condition, with information to the patient or her/his surrogate. While ordering DNAR on the patient's medical case record, every effort should be made to treat the underlying disease and continue optimal medical care with compassion. This policy document describes the principles for DNAR, offers an algorithm and format for its implementation, and guidance on frequently asked questions.

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Conflict of interest statement

None

Figures

Figure
Figure
Algorithm for Do Not Attempt Resuscitation (DNAR) decision-making.
See this image and copyright information in PMC

Comment in

  • DNAR Guidelines: Supporting end-of-life decisions.
    Timms O. Timms O. Indian J Med Ethics. 2020 Jul-Sep;V(3):180-181. doi: 10.20529/IJME.2020.081. Indian J Med Ethics. 2020. PMID: 33295283
  • Indian Council of Medical Research consensus guidelines on 'Do Not Attempt Resuscitation': Communication is key.
    Jeba J, Singh A, Munday D. Jeba J, et al. Indian J Med Res. 2020 Oct;152(4):427-428. doi: 10.4103/ijmr.IJMR_2119_20. Indian J Med Res. 2020. PMID: 33380709 Free PMC article. No abstract available.
  • Authors' response.
    Mathur R, Garg P, Muthuswamy V, Mathur P. Mathur R, et al. Indian J Med Res. 2020 Oct;152(4):428. doi: 10.4103/0971-5916.305171. Indian J Med Res. 2020. PMID: 33380710 Free PMC article. No abstract available.
  • Centring patient autonomy in DNAR decisions.
    Timms O, Pandya SK, Jesani A, Srinivasan S. Timms O, et al. Indian J Med Ethics. 2020 Oct-Dec;V(4):1-3. doi: 10.20529/IJME.2020.096. Indian J Med Ethics. 2020. PMID: 34018951
  • DNAR Guidelines from ICMR: Meeting a felt need.
    Mani RK, Simha S, Gursahani R, Mehta D, Garg P, Mathur R. Mani RK, et al. Indian J Med Ethics. 2020 Oct-Dec;V(4):1-5. doi: 10.20529/ijme.2020.095. Indian J Med Ethics. 2020. PMID: 34018952
  • Do not attempt resuscitation.
    Sampathkumar A. Sampathkumar A. Indian J Med Res. 2021 Jul;154(1):154-155. doi: 10.4103/ijmr.IJMR_200_21. Indian J Med Res. 2021. PMID: 34782542 Free PMC article. No abstract available.
  • Authors' response.
    Indian Council of Medical Research Expert Group on DNAR. Indian Council of Medical Research Expert Group on DNAR. Indian J Med Res. 2021 Jul;154(1):154-155. doi: 10.4103/0971-5916.329911. Indian J Med Res. 2021. PMID: 34782543 Free PMC article. No abstract available.

References

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