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Specific Ethical Issues at the End of Life 

Specific Ethical Issues at the End of Life
Chapter:
Specific Ethical Issues at the End of Life
Author(s):

Robert C. Macauley

DOI:
10.1093/med/9780199313945.003.0004
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date: 22 May 2019

A specific application of advance care planning has to do with determining the “code status” of a patient. Many of the terms used to document this status are misunderstood or carry unfortunate connotations, such as “DNR.” It is more appropriate to refer to a “Do Not Attempt Resuscitation” (DNAR), to emphasize the uncertainty as to whether attempted resuscitation will be successful. Code status is especially relevant to patients who “want everything,” which may include high-burden and low-benefit procedures. Time-limited trials and Do Not Escalate Treatment orders may be considered in those situations. There may also be situations when a patient’s refusal should be overridden, when the patient’s decision-making capacity is compromised.

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