Do Not Attempt Cardiopulmonary Resuscitation Orders

Given the medical situation, you believe your elderly patient, Tim, should not be for resuscitation because the harms of cardiopulmonary resuscitation (CPR) are significant for a person in his physical condition (it is likely that his ribs may break with compressions) and, even if successful at restarting his heart, it is likely that this will only prolong his life by a few months given his past history. The nursing home manager informs you that Tim has an extensive family and at least one member visits him daily. During one of your weekly visits, you decide to chat with Tim about his end-of-life wishes. His grandson is also present. Tim does not recognize you from your previous visits, but Dave, Tim’s grandson, tells you that he seems very settled in the nursing home. His grandfather loves to have visits from his family, ‘even though he doesn’t really know who we are’ and he takes great pleasure from the small things in his life, like sitting in the sun in a comfy armchair with a cup of tea.

  • Who makes a decision whether to make a Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) order?
  • Does this need to be discussed with the patient/the patient’s family/carers?
  • What if the family objects to the DNACPR?

Apply Theory (Specific Professional Healthcare Competencies + Clinical Medical Ethical Principles) to Practice in order to provide Optimal Patient-Centered Care (OPCC)