New do-not-resuscitate policies.

Abstract

The article by Murphy and Finucane on new do-not-resuscitate (DNR) policies 1 leaves the reader perplexed. First, the policies are not new; second, the rationale for the new policies is contradicted by the authors themselves and the data available in the literature. The new DNR policies the authors propose are really a new procedure for development of DNR policies. The idea is that community members along with hospital officials, professional groups, and governmental groups propose new DNR policies for the hospitals of a city. This community-based development of hospital policies is hardly a novel idea. Oregon health decisions began developing what they called "informed community consent" on the whole range of terminating care issues. 2 Similarly, for years, Emanuel 3 has advocated community-based decision-making not just for terminating care but also for allocating scarce medical resources. In his book, 4 he has elaborated the theoretical justification for such community-based policy