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Do Not Resuscitate Legal and Ethical Issues Essay


DNR, Do Not Resuscitate, is an order that alerts medical professionals not to perform cardiopulmonary resuscitation, CPR, on an individual. CPR consists of life saving methods such as procedures that can involve mouth to mouth resuscitation to using a defibrillator, intubation, and using cardio tonic drugs to bring the patient back to life. DNR orders is a legal document that has been sustained by the individual or proxy, typically is for patients that are seriously ill or may be terminally ill, preventing aggressive efforts to bring them back to life. DNR enables a person to exercise their right to autonomy, to make decisions about their healthcare in case they are unable to do so in the future. In this paper I will be analyzing the requirements of New Jersey’s DNR. Secondly I will be identifying the requirements of three hospitals DNR’s in New Jersey. The three hospitals will be Jersey City Medical center, St. Joseph’s Hospital, and Hackensack Medical Center; I will examine the differences and similarities between the three hospital DNR requirements and address the following: what they are and which one should be followed. Lastly the paper will explain how a DNR is applied if a patient is under hospice care and the EMT’s are called.

Requirements for New Jersey Do Not Resuscitate Orders State of N.J. www.state.nj.us/health/ems/dnr_introduction.shtml This is the State of New Jersey Department of Health website. This website contains the requirements for the state of N.J. This also contains information of the guidelines for physicians, policies for EMS personal, and Do Not Resuscitate brochure. This web site is valuable for the research paper in the understanding of the states requirments and policies. New Jersey Do Not Resuscitate (DNR) http://www.njha.com/media/33214/DNRGuidelines.pdf. This website provides the state’s education for guidelines for health care professional, patients and their families. This also contains important information about the DNR background and history to further understand the requirements.

The website also includes physician guidelines, EMS policy, how to get a valid out of hospital DNR, bracelet guidelines, and an educational brochure for family members. The website will allow me to identify the requirements of New Jersey’s DNR policy and also provides tools for the patient and their family. DNR’s Advanced Directives-NJ http://www.njha.com/media/33214/DNRGuidelines.pdf. \This website is the NJ Hospice and Palliative Care Organization; this will enrich my knowledge about hospice care, DNR orders, Advanced Directives, and living wills. Duke, G., Thompson, S., & Hastie, M. (2007). Factors influencing completion of advanced directives in hospitalized patients. International Journal Of Palliative Nursing, 13(1), 39-43 This was retrieved form the Ashford library; this is a journal article that discusses the completion of DNR forms and the importance in protecting the patient’s right in making decisions for end of life care. The article gives important information about DNR and also describes assessment tools that are used to better educate the patient.

Advanced Directives- Jersey City Medical Center https://www.libertyhealth.org/pdf/LibertyHealth_Advance_Directive.pdf St Joseph’s Health care- https://www.stjosephshealth.org/patients-and-families/your-hospital-stay-information/24-your-hospital-stay-information Advanced Directives-Hackensack Medical Center http://www.hackensackumc.org/assets/1/7/advdirectives.pdf. This is the Jersey City Medical Center’s, St. Joseph’s Hospital’s, and Hackensack Universities advance directive information and DNR forms. They provide education for the patient and or families. This will provide me the information to examine the differences and similarities between the states and the three hospitals DNR requirements to address the following questions: what are they and which one should be followed.

DNR is applied under hospice care and EMT’s are called Do Not Resuscitate Orders State of N.J. www.state.nj.us/health/ems/dnr_introduction.shtml This website provides information on how a DNR is applied if patients are under hospice care and the EMT’s have been called. This will be very important in the research paper. Providing information and ethic realization to issues when DNR guidelines and a call for emergent services on a hospice patient. This is the State of New Jersey Department of Health website. This website contains the information how DNR is applied if a patient is under hospice care and EMT’s are called. From researching the information provided this will greatly help me explain and understand the issues involving DNR document and a call for to the EMT’s to provide help. Van Leuven, K. (2012). Advanced care planning in health service users. Journal Of Clinical Nursing, 21(21/22), 3126-3133. doi:10.1111/j.1365-2702.2012.04190.x This was retrieved form Ashford University Library; this journal article provides information of advanced directives and DNR orders.

This is critical to my research paper, it will help me to understand and analysis various situations such as EMT’s being called with a patient that has a DNR. Croke, E., & Daguro, P. (2005). Liability for the health care provider: non-implementation of patients’ advanced directives. Journal Of Legal Nurse Consulting, 16(2), 19-24. This was also retrieved form Ashford Universities library, the journal artical explains how a DNR should be kept with a patient and should also be kept in the patient’s permanent medical record. DNR orders should be honored by health care professional including EMT’s.

The information also explains that a living will is not a DNR and that a bracelet is one of the best ways for EMT’s to recognize a patient’s wishes. Taghavi, M., Simon, A., Kappus, S., Meyer, N., Lassen, C., Klier, T., & … Wiese, C. (2012). Paramedic’s experiences and expectations concerning advance directives: A prospective, questionnaire-based, bi-centre study. Palliative Medicine, 26(7), 908-916. doi:10.1177/0269216311419885 This was also retrieved form the Ashford library; it is a questionnaire based investigation from the EMT’s perspective. It explains their concerns for improved guidelines on end of life decisions and to not provide cardiopulmonary resuscitation in palliative care patients.

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