“不要复苏”（DNR）、“不要尝试心肺复苏”（DNAR）还是“允许自然死亡”（AND）？语言很重要吗？
DNR, DNAR, or AND? Is Language Important?
作者信息
Breault Joseph L
机构信息
Chair, Institutional Review Boards, Ochsner Clinic Foundation, New Orleans, LA.
出版信息
Ochsner J. 2011 Winter;11(4):302-6.
Abstract
The American Heart Association in 2005 moved from the traditional do not resuscitate (DNR) terminology to do not attempt resuscitation (DNAR). DNAR reduces the implication that resuscitation is likely and creates a better emotional environment to explain what the order means. Allow natural death (AND) is the name recommended in some settings to make the meaning even clearer. Most hospitals still use the obsolete DNR term. Medical staffs should consider moving to DNAR and in some settings to AND. Language is important.
摘要
美国心脏协会在2005年从传统的“不要复苏”（DNR）术语转变为“不尝试复苏”（DNAR）。DNAR减少了复苏可能会进行的暗示，并营造了一个更好的情感环境来解释该医嘱的含义。“允许自然死亡”（AND）是在某些情况下推荐使用的名称，以使含义更加明确。大多数医院仍在使用过时的DNR术语。医务人员应考虑采用DNAR，在某些情况下采用AND。语言很重要。
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本文引用的文献
1
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Fam Pract. 2011 Oct;28(5):505-15. doi: 10.1093/fampra/cmr023. Epub 2011 May 18.
2
Hospital do-not-resuscitate orders: why they have failed and how to fix them.医院不复苏令：它们为何失败以及如何改进。
J Gen Intern Med. 2011 Jul;26(7):791-7. doi: 10.1007/s11606-011-1632-x. Epub 2011 Feb 1.
3
Part 3: ethics: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.第三部分：伦理学：2010年美国心脏协会心肺复苏及心血管急救指南。
Circulation. 2010 Nov 2;122(18 Suppl 3):S665-75. doi: 10.1161/CIRCULATIONAHA.110.970905.
4
Reviving the conversation around CPR/DNR.重新探讨心肺复苏术（CPR）/ 不施行心肺复苏术（DNR）的问题。
Am J Bioeth. 2010 Jan;10(1):61-7. doi: 10.1080/15265160903469328.
5
Family witnessed resuscitation: the views and preferences of recently resuscitated hospital inpatients, compared to matched controls without the experience of resuscitation survival.
Resuscitation. 2009 Sep;80(9):1070-3. doi: 10.1016/j.resuscitation.2009.05.020. Epub 2009 Jul 10.
6
Survival from in-hospital cardiac arrest during nights and weekends.夜间及周末院内心脏骤停的生存率。
JAMA. 2008 Feb 20;299(7):785-92. doi: 10.1001/jama.299.7.785.
7
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Resuscitation. 2006 Nov;71(2):152-60. doi: 10.1016/j.resuscitation.2006.02.022. Epub 2006 Sep 20.
8
2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.2005年美国心脏协会心肺复苏及心血管急救指南。
Circulation. 2005 Dec 13;112(24 Suppl):IV1-203. doi: 10.1161/CIRCULATIONAHA.105.166550. Epub 2005 Nov 28.
9
Death wish: resuscitating self-determination for the critically ill.死亡愿望：恢复重症患者的自主决定权
Ariz Law Rev. 1993 Spring;35(1):23-85.
10
Decisions Relating to Cardiopulmonary Resuscitation: a joint statement from the British Medical Association, the Resuscitation Council (UK) and the Royal College of Nursing.关于心肺复苏的决策：英国医学协会、英国复苏委员会和皇家护理学院的联合声明
J Med Ethics. 2001 Oct;27(5):310-6; discussion 317-23. doi: 10.1136/jme.27.5.310.
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