["Do not resuscitate" orders in Danish medical wards. A questionnaire].

INTRODUCTION

Do not resuscitate (DNR) orders should prevent pointless life-prolonging procedures. Practicing DNR orders in Denmark is not described and there are no national guidelines. The purpose of this study is to clarify how DNR orders, patient autonomy, and living wills are handled in a Danish medical ward.

MATERIALS AND METHODS

All 193 medical wards in Denmark received questionnaires (Figure 1) addressed to the medical Head of Department. 138 (71.5 %) questionnaires were analysed.

RESULTS

127 (92 %) wards had DNR orders. In 52 (38 %) wards DNR orders could include reduction of other treatment modalities. Competent patients were 'always' asked in 20 (14 %), 'often' in 34 (25 %), 'seldom' in 59 (43 %), and 'never' in 12 (9 %) of the wards prior to DNR decisions. Spouses were asked more often than the patient; 'always' in 31 (22 %), 'often' in 68 (49 %), 'seldom' in 21 (15 %), and 'never' in 4 (3 %) of the wards. The Danish Living Will Registry was contacted 'always' in 2 (1 %), 'often' in 15 (11 %), 'seldom' in 68 (49 %), and 'never' in 37 (27 %) of the wards. 112 (81 %) wards did not have a written guideline on DNR orders.

CONCLUSION

Patients should be asked more often prior to DNR decisions. Health workers should contact The Danish Living Will Registry more frequently. As a decision aid and in order to strengthen both health workers' and patients' legal rights, a national guideline on DNR ordering could be established.