Miller R J
Hosp J. 1991;7(4):67-77. doi: 10.1080/0742-969x.1991.11882711.
Recent passage of the Patient Self-Determination Act will require health care providers to develop policies concerning patients' wishes for life prolonging therapy. Since American hospice programs have generally had do-not-resuscitate (DNR) policies since their inception we thought it timely to review the experience of hospice programs with the DNR order. Many programs assume that a signed DNR order is a prerequisite to being accepted as a hospice patient. Other programs are more flexible. This lack of uniformity exposes the unresolved issue within the hospice community as to what is considered appropriate hospice or palliative care. Problems with paramedics responding to 911 calls and not respecting DNR orders or living wills are also discussed.
最近通过的《患者自主决定法案》将要求医疗服务提供者制定有关患者对延长生命治疗意愿的政策。由于美国临终关怀项目自设立以来普遍实行了“不要复苏”（DNR）政策，我们认为此时回顾临终关怀项目执行DNR医嘱的经验是适时的。许多项目认为签署DNR医嘱是被接纳为临终关怀患者的先决条件。其他项目则更为灵活。这种缺乏统一性暴露了临终关怀界内部关于什么被视为适当的临终关怀或姑息治疗这一未解决的问题。还讨论了护理人员对911呼叫做出反应时不尊重DNR医嘱或生前预嘱的问题。
