The Ethical Dilemma Regarding 'Do Not Resuscitate' Orders.

Essay by mistiblu33 May 2007

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Whilst on placement on an Adult Rehabilitation Ward, I observed an ethical dilemma. The patient concerned was issued with 'Do Not Resuscitate' (D.N.R.) order. This decision was reached after the consultant, named nurse, patient and the patient's family discussed together and based their decision on the patient's age, condition, quality of life and wishes.

The UKCC 'Code of Professional Conduct' (1992) states that every registered nurse, midwife, and Health Visitorshould act, at all times, in such a manner as to … promote and safeguard the interests and well-being of patients and clients [and to] ensure that no action or omission on your part, or within your sphere of responsibility, is detrimental to the interests, condition or safety of patients and clients.

Therefore, how does withholding life-saving treatment, comply with the 'Code of Professional Conduct'?The decision not to resuscitate conflicts with this clause of a document that aims to define and develop professional standards to protect the public and offer direction regarding the suitable conduct of the profession (Kenworthy et al, 1999).

The conflict arises because the decision not to resuscitate could be seen as not promoting the well being of the patient and an omission on the nurse's part, causing detrimental consequences (Rumbold, 1999).

On the other hand, clause seven of the 'Code of Professional Conduct' states that a nurse should "recognise and respect the uniqueness and dignity of each patient and client and respond to their need of care" (UKCC, 1992). The nurse who does not comply with a patient's wish to die with dignity and not to be resuscitated, could be seen as violating this clause (Rumbold, 1999).

There are several viewpoints regarding the use of cardio-pulmonary resuscitation (C.P.R.). One such viewpoint is that it is never morally acceptable to withhold C.P.R. This view stems from the...