Use of patient/health proxy authorised do-not-resuscitate (DNR) or do-not-attempt-resuscitation (DNAR) orders is widespread in palliative, hospice and hospital-based chronic illness care. Such orders often reflect self-determination, avoidance of futile care and quality of dying principles. Reports during COVID-19 of physicians writing DNR/DNAR orders for people with intellectual disabilities at rates higher than the general population amplify past concerns about the value placed on their lives. Yet, absence of a DNR/DNAR or processes to permit one when someone cannot consent may result in painful and unnecessary prolongation of life. This chapter considers rationales for DNR/DNAR orders, use among people with intellectual disabilities, advance care planning, protocols when an individual is unable to consent and strategies for oversight of DNR/DNAR orders.
CITATION STYLE
McCallion, P., Ferretti, L. A., & McCarron, M. (2022). Use of Do-Not-Resuscitate Orders. In End of Life and People with Intellectual and Developmental Disability: Contemporary Issues, Challenges, Experiences and Practice (pp. 407–434). Springer International Publishing. https://doi.org/10.1007/978-3-030-98697-1_15
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