Beed Martin, de Beer Thearina, Brindley Peter G
Intensive Care and Anaesthesia, Nottingham University Hospital, Nottingham NG5 1PB, UK.
Critical Care Medicine, Dosseter Ethics Centre, Anaesthesiology and Pain Medicine, University of Alberta, Edmonton, Canada, T6G2B7.
Resuscitation. 2015 Jan;86:31-7. doi: 10.1016/j.resuscitation.2014.10.002. Epub 2014 Oct 29.
To review UK newspaper reports relating to Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions in order to identify common themes and encourage dialogue.
An online media database (LexisNexis(®)) was searched for UK Newspaper articles between 1993 and 2013 that referenced DNACPR decisions. Legal cases, concerning resuscitation decisions, were identified using two case law databases (Lexis Law(®) and Westlaw(®)), and referenced back to newspaper publications. All articles were fully reviewed.
Three hundred and thirty one articles were identified, resulting from 77 identifiable incidents. The periods 2000-01 and 2011-13 encompassed the majority of articles. There were 16 high-profile legal cases, nine of which resulted in newspaper articles. Approximately 35 percent of newspaper reports referred to DNACPR decisions apparently made without adequate patient and/or family consultation. "Ageism" was referred to in 9 percent of articles (mostly printed 2000-02); and "discrimination against the disabled" in 8 percent (mostly from 2010-12). Only five newspaper articles (2 percent) discussed patients receiving CPR against their wishes. Eighteen newspaper reports (5 percent) associated DNACPR decisions with active euthanasia.
Regarding DNACPR decision-making, the predominant theme was perceived lack of patient involvement, and, more recently, lack of surrogate involvement. Negative language was common, especially when decisions were presumed unilateral. Increased dialogue, and shared decision-making, is recommended.
回顾英国报纸上与不进行心肺复苏（DNACPR）决策相关的报道，以识别常见主题并促进对话。
在在线媒体数据库（LexisNexis(®)）中搜索1993年至2013年间提及DNACPR决策的英国报纸文章。使用两个判例法数据库（Lexis Law(®)和Westlaw(®)）识别有关复苏决策的法律案件，并追溯到报纸出版物。对所有文章进行了全面审查。
共识别出331篇文章，源自77起可识别的事件。2000 - 01年和2011 - 13年期间涵盖了大部分文章。有16起备受瞩目的法律案件，其中9起引发了报纸文章报道。约35%的报纸报道提到DNACPR决策显然是在未与患者和/或家属进行充分协商的情况下做出的。9%的文章提到了“年龄歧视”（大多发表于2000 - 02年）；8%的文章提到了“对残疾人的歧视”（大多来自2010 - 12年）。只有五篇报纸文章（2%）讨论了违背患者意愿进行心肺复苏的情况。18篇报纸报道（5%）将DNACPR决策与主动安乐死联系起来。
关于DNACPR决策，主要主题是人们认为缺乏患者参与，以及最近缺乏替代决策者的参与。负面措辞很常见，尤其是当决策被认为是单方面做出的时候。建议加强对话和共同决策。
