Articles  |   March 2013
ACE Question
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Education / CPD / Articles
Articles   |   March 2013
ACE Question
ASA Monitor 03 2013, Vol.77, 36.
ASA Monitor 03 2013, Vol.77, 36.
A patient with a bowel obstruction presents to the operating room for an exploratory laparotomy. He has metastatic colon cancer, and there is a do-not-resuscitate (DNR) order on his chart. Which of the following is the MOST appropriate action to take?
The presence of a DNR order does not preclude a patient from undergoing surgery and does not require cancellation of the surgery. These patients are appropriate candidates for some surgical procedures, especially palliative procedures that may improve the patient’s comfort or quality of life. In fact, approximately 15 percent of patients with DNR orders undergo surgery. Most institutions have a policy in place for how to handle this situation. ASA also has provided guidelines. Policies that automatically suspend a DNR order during surgery and anesthesia are not recommended by ASA or ethics experts because such policies jeopardize the patient’s autonomy.
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