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Resuscitation decisions: an exploration of the problems with the "Do Not Attempt Cardiopulmonary Resuscitation" form and the development and evaluation of a new approach
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Fritz, Zoë (2016) Resuscitation decisions: an exploration of the problems with the "Do Not Attempt Cardiopulmonary Resuscitation" form and the development and evaluation of a new approach. PhD thesis, University of Warwick.
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Official URL: http://webcat.warwick.ac.uk/record=b3063534~S1
Abstract
Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) forms exist to provide immediacy and clarity of instruction in the event of a cardiorespiratory arrest; they are written either at a patient’s request, or because a clinical decision has been made that a patient would be unlikely to survive attempted cardiopulmonary resuscitation. They are extremely common, with around 92% of patients who die in hospital dying with a DNACPR decision in place.(1)
While working as a physician in the acute care setting and in intensive care, I became concerned about ethical problems with the use, interpretation and unintended consequences of DNACPR decisions: they were considered in an ad hoc manner; often documented without discussion with patients; and appeared to act as an unofficial triage marker, with patients with DNACPR forms being treated differently from those without them.
A review of the literature revealed empirical research which supported my concerns, but a lack of contemporary evidence in the UK about the use or understanding of DNACPR decisions and forms. Supported by my colleague, Dr. Jonathan Fuld, I successfully applied for an NIHR Research for Patient Benefit Grant to conduct research to further assess these problems in the UK setting and to develop and evaluate an alternative approach.
Item Type: | Thesis (PhD) | ||||
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Subjects: | R Medicine > RC Internal medicine | ||||
Library of Congress Subject Headings (LCSH): | CPR (First aid) -- Moral and ethical aspects., Do-not-resuscitate orders., Resuscitation -- Moral and ethical aspects., Medical ethics., Cardiac resuscitation., Resuscitation -- Legal aspects., Medicine -- Decision making. | ||||
Official Date: | September 2016 | ||||
Dates: |
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Institution: | University of Warwick | ||||
Theses Department: | Warwick Medical School | ||||
Thesis Type: | PhD | ||||
Publication Status: | Unpublished | ||||
Supervisor(s)/Advisor: | Fuld, Jonathan ; Slowther, Anne ; Griffiths, Frances | ||||
Sponsors: | National Institute for Health Research (NIHR) | ||||
Extent: | 60 leaves : illustrations, forms | ||||
Language: | eng |
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