Commentary
Do-not-resuscitate orders, unintended consequences, and the ripple effect
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Correspondence: J Claude Hemphill chemphill@sfgh.ucsf.edu
Department of Neurology, Room 4M62, San Francisco General Hospital, 1001 Potrero Avenue, San Francisco, CA 94110, USA
Critical Care 2007, 11:121 doi:10.1186/cc5687
Published: 2 March 2007Abstract
Do-not-resuscitate (DNR) orders are commonly implemented in the critical care setting as a prelude to end-of-life care. This is often based on presumed prognosis for favorable outcome and interpretation of patient, family, and even physician wishes. While DNR orders explicitly apply only to an individual patient, the hospital culture and milieu in which DNR orders are implemented could potentially have an overall impact on aggressiveness of care across patients. As illustrated by the example of intracerebral hemorrhage, this may unexpectedly influence outcome even in patients without DNR orders in place.