Do not resuscitate orders from the perspective of oncology patients and their relatives

Abstract

This study aims to determine the perspective of oncological patients and their families in relation to the Do Not Resuscitate Order (DNR). A questionnaire was applied to 104 oncological patients and 100 relatives, who were attended to by the oncology service of Hospital Universitario Santa Terezinha, Joacaba, Santa Catarina, Brazil in 2014. The term DNR was unknown by 81.73% of the patients and by 82% of the relatives. After clarifying its meaning, 65.4% of patients and 67% of the relatives were favorable towards DNR in the event of cardiorespiratory failure of the patient, in the final phase of the terminal disease. A shared decision between the patients, their relatives, and the doctor was preferred by 58.65% of patients and 73% of the relatives; a decision prompted by the initiative of the doctor accompanying the treatment was preferred by 60.58% of the patients and 72% of the relatives. The execution of the DNR by the patient him/herself was considered important by 63.47% of the patients and 68.63% of the relatives, and the introduction of the DNR in Brazil was considered important by 75% of the patients and 74% of the relatives. It is concluded that the majority of the patients and relatives did not know the term “Do Not Resuscitate Order”, but were favorable to the introduction of the procedure in Brazil, the personal realization through the shared decision, and that the approach would occur during medical visits. The results of this study enable us to infer the need to broaden the discussion on DNR, in the ethical social scope, in order to issue guidance to ensure the autonomy of patients who are in the terminal phases of life.