DNR in the OR-Reply

Abstract

In Reply. —I appreciate the thoughtful responses to my article and the opportunity to respond. Part of Dr Couper's difficulty with intraoperative DNR orders relates to his broad use of the term resuscitation . He applies the term not only to intraoperative arrest but to events that can lead to arrest. By contrast, I specifically defined resuscitation as an attempt to reverse intraoperative cardiac arrest. It is only by distinguishing arrest from prearrest interventions, like vasopressor and fluid support, that we can avoid confusion in this matter. Drs Franklin and Rothenberg write that my approach to DNR policy fail[s] to mention... the patient's option to have life support discontinued. They propose a therapeutic trial of surgery with a guarantee that life support will be discontinued in particular circumstances. I should point out that this option was addressed in my article's policy considerations. I wrote that during discussion, one may well find