The Iranian physicians attitude toward the do not resuscitate order

Fallahi, Masood; Banaderakhshan, Homayion; Abdi, Alireza; Borhani, Fariba; Kaviannezhad, Rasool; Karimpour, Hassan Ali

doi:10.2147/jmdh.s105002

Cited by 24 publications

(27 citation statements)

References 17 publications

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“…The findings of other studies conducted in Iran have indicated that in cases where patients experience terminal illness, dilemma in choosing whether to prolong treatment or allow the normal process of dying to take place is a key challenge for physicians yet is not considered futile (13,14). According to the results of another study in Iran, despite the positive attitude of doctors towards DNR orders, absence of a clear legal guidance regarding this issue leads to various problems in physician's decision-making and necessitates clear instructions/rules from governing bodies in the country (15). Notably, diseases, as one of the factors giving rise to major changes in the lives of people, affect both the patients and their families (16).…”

Section: Introductionmentioning

confidence: 99%

Ethical Challenges in Pediatrics from the Viewpoints of Iranian Pediatric Residents

et al. 2017

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Background: Some ethical challenges have emerged along with advances within the field of pediatrics. Meanwhile, the residents of pediatrics face particular ethical challenges, since they have different roles in their professional career as educators, students, advocators, and clinicians. Objectives: The aim of the present study was to identify ethical challenges in the field of pediatrics from the viewpoints of Iranian pediatric residents Methods: This cross-sectional study was conducted during 9 months. The studied population consisted of 90 residents of pediatrics studying at Tehran University of Medical Sciences in Tehran, capital of Iran. Sampling was conducted in the form of census counts of a 32-item instrument that evaluated ethical challenges in the field of pediatrics. Validity and reliability of this questionnaire were evaluated by experts in the field of medical ethics and pediatrics. Data were analyzed using the SPSS software using descriptiveanalytic statistic methods. Results: The most serious ethical challenges in the field of pediatrics were providing enough information to obtain informed consent (4.74 ± 0.22), dealing effectively with the conflicts of decision-making by the sick children and their families (4.68 ± 0.14), giving bad news to the sick children or their parents as appropriately as possible (4.64 ± 0.18), and taking necessary actions in dealing with cases of child maltreatment (4.62 ± 0.16), respectively. In addition, based on linear regression analysis, there was a significant correlation (P = 0.03, r = 0.059) between the residents' gender and their views towards ethical conflicts; female residents paid more attention to these challenges than male residents. Conclusions: Paying attention to ethical challenges in the field of pediatrics helps the authorities provide favorable conditions in clinical settings. Therefore, resulting in less ethical challenges in similar situations.

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Section: Introductionmentioning

confidence: 99%

Ethical Challenges in Pediatrics from the Viewpoints of Iranian Pediatric Residents

et al. 2017

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“…Other studies also stated that futile therapeutic interventions[ 4 22 ] and the likelihood of CPR failure were some factors affecting decision-making on the DNR order. [ 11 23 ] In other studies, poor medical conditions and prognosis were mentioned as the underlying factors of the DNR order. [ 18 ] In many European countries, when doctors do not believe in the success of CPR or are informed of the CPR's risks, they do not recommend this procedure.…”

Section: Discussionmentioning

confidence: 99%

“…[ 10 ] The attitudes of health-care staff including nurses and physicians toward those patients who are spending the final days of their life have always been a major challenge influencing the decision for performing CPR. [ 6 ] This challenge has been perceived in different ways in different countries[ 11 ] because it is influenced by a wide range of cultural, religious, ethnical, and geographical factors. [ 12 ] In this regard, studies conducted in western countries indicted the positive attitudes of health-care professionals toward the DNR order.…”

Section: Introductionmentioning

confidence: 99%

“…[ 6 13 ] In a few studies conducted in Muslim countries have shown the presence of a negative attitude toward the DNR order. [ 11 14 15 ] However, conflicting perspectives about the DNR order in these countries have also been reported. [ 16 17 ] The limited number of studies and contradictory results about the DNR order in Islamic countries,[ 11 14 17 ] recommendations for further studies,[ 15 ] the prevalence of the nonstandard, informal and verbal DNR order in many Islamic countries,[ 18 ] and a lack of knowledge on the experiences of health-care providers on the DNR order in these countries motivated the researchers to conduct a study.…”

Section: Introductionmentioning

confidence: 99%

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Do-not-resuscitate order: The experiences of iranian cardiopulmonary resuscitation team members

Assarroudi

Nabavi

Ebadi

et al. 2017

Indian J Palliat Care

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Background:One dilemma in the end-of-life care is making decisions for conducting cardiopulmonary resuscitation (CPR). This dilemma is perceived in different ways due to the influence of culture and religion. This study aimed to understand the experiences of CPR team members about the do-not-resuscitate order.Methods:CPR team members were interviewed, and data were analyzed using a conventional content analysis method.Results:Three categories and six subcategories emerged: “The dilemma between revival and suffering” with the subcategories of “revival likelihood” and “death as a cause for comfort;” “conflicting situation” with the subcategories of “latent decision” and “ambivalent order;” and “low-quality CPR” with the subcategories of “team member demotivation” and “disrupting CPR performance.”Conclusion:There is a need for the development of a contextual guideline, which is required for respecting the rights of patients and their families and providing legal support to health-care professionals during CPR.

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“…The general incidence of these resuscitation-related injuries have been reported 21%-65%. 5,6 In the late 1960s, numerous reports regarding the complications of CPR and augmentation and prolongation of patients' suffering, due to the temporary return of physiological stability after resuscitation, were submitted. Considering the presence of a condition in which medical staff believe that resuscitation would not have any benefits, withholding the "resuscitation code" or not proceeding for complete resuscitation, expressions such as "demonstrative code", "slow code", etc.…”

mentioning

confidence: 99%

Attitude of Nurses in Intensive Care Units towards Do Not Resuscitate order

Naghshbandi

Salmasi

Parsian

et al. 2019

J Anal Res Clin Med

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Introduction : Do Not Resuscitate (DNR) order has been studied ethically, legally, and religiously in different countries after presentation by the American Medical Association (AMA) in 1974. This study was conducted to investigate the attitude of nurses in intensive care units (ICUs) of hospitals of Tabriz University of Medical Sciences, Tabriz, Iran, towards DNR order. Methods: 255 nurses working in ICUs were included in a descriptive-analytical study at Tabriz University of Medical Sciences in 2018. The utilized checklist contained two sections: demographic information and 11 questions with a 5-point Likert scale about the attitude towards the DNR order. The scores relating to each question were collected and analyzed. Results: The average of the total score of the questionnaire was 29.97 8.39. The attitudes of participants were negative in all questions except for the 8th and 11th questions. The total score of the questionnaire was 29.49 8.09 in the group with work experience of 15 years and less and 32.49 9.50 (P = 0.036) in the group with a more than 15 years of work experience; which indicates more positive attitude towards the DNR order in individuals with more work experience. Conclusion: The results showed that in general, the participant nurses did not have positive attitudes concerning the DNR order; however, people with more than 15 years of work experience had more positive attitude towards this order and the investigation of this factor and the causes of its impact on the change of people’s attitude should be carried out in further studies.

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The Iranian physicians attitude toward the do not resuscitate order

Cited by 24 publications

References 17 publications

Ethical Challenges in Pediatrics from the Viewpoints of Iranian Pediatric Residents

Ethical Challenges in Pediatrics from the Viewpoints of Iranian Pediatric Residents

Do-not-resuscitate order: The experiences of iranian cardiopulmonary resuscitation team members

Attitude of Nurses in Intensive Care Units towards Do Not Resuscitate order

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