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Tuesday, November 17, 2015

DNR Does NOT Mean Comfort Care Only


The screenshot above is from an interactive Medscape article, Applying End-of-Life Documents in the Real World.  As you can see, 81% correctly identified the Do Not Resuscitate (DNR) status from a POLST or Living Will.

76% of medical professionals interpreted DNR to also mean patients only want comfort care/end-of-life care.

In this type of healthcare climate, any kind of advance directive is risky to have as it is very likely to be over-interpreted such that patients are not receiving the care they desire.

The Medscape article was written by Dr. Ferdinando Mirarchi, the lead investigator of the The Realistic Interpretation of Advance Directives (TRIAD) studies, all of which demonstrate widespread over-interpretation of these orders throughout the medical system.

His suggestion: ask the patient!  He also advocates for a trial of treatment that can be withdrawn if there is no benefit after 24 to 48 hours--a far cry from talking patients out of treatments, a practice commonly promoted today.



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