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DNR declaration - emergency medical system nurses’ opinions

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Goniewicz M., Rzońca P., Klukow J., Pawlikowski J., Sak J., Goniewicz K.
Open Medicine
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2013
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vol. 8
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issue 1
69-74
EN
Advance directive and other declarations of will made by patients in a case of mental illness still raise ethical and legal issues. In Poland there is no legal regulation, neither research about code of conduct in situation of do not attempt resuscitation. There are also not enough studies regarding Healthcare workers’ opinion about DNAR declaration (Do Not Attempt Resuscitation). The study is aimed at finding out emergency medical system nurses opinion on the subject of enforcing do not attempt resuscitation in situation of circulatory and respiratory arrest. Methods: The research was conducted by means of the diagnostic survey method applying a self - constructed questionnaire. The study was carried out among 82 (100%) nurses, from September to December 2011. Obtained information were analyzed statistically, Chi-square of independence with assumed p ≤ 0.05. level of significance was used for statistical analysis. Results: The study of the respondents’ opinion shows that 67% Healthcare employees think that DNAR declaration should be obligatory in Poland. Contrary opinion has 7.3% of respondents. In their opinion the decision to refrain from resuscitating should be made by attending physician − 46.3% and medical board − 29.3%. Information enclosed within DNAR declaration, in most of respondents’ opinion − 59.5%, should be only passed on in written form. Conclusions: Majority of respondents agree that patients have a right to refrain from resuscitating as a self − determination act. Respondents concur the introduction of DNAR declaration in Polish Healthcare system. In respondents’ opinion that decision should be required in written form and an attending physician should decide about its implementation, what violates the existing rule. The execution of living will declaration raises ethical issues. Additionally, it also appears as public/social problem. The last stage of incurable disease is given as justifiable circumstances of DNAR.
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