INTRODUCTION
The purpose of resuscitation is saving life, better health, relieving pain, decreasing cobormidities and respecting the patient’s decisions, rights and privacy (1). Additionally, regarding cardiopulmonary resuscitation (CPR), the very important aim is to prevent death (2). Although general rule being the urgent treatment for cardiac arrest, there are several occasions where not performing CPR is more convenient. In a study, it is shown that 54,9% of patients would not benefit from CPR (3). CPR should be performed to patients whom will benefit the most. Inevitable failure should not be accepted.
Do Not Attempt Resuscitation (DNAR) means do not perform resuscitation. However, in various centers Allow Natural Death (AND) replaces DNAR (1). DNAR definition should be well understood. Some physicians understand DNAR just not performing CPR whereas some advocate not providing any medical support to the patient. Not providing any medical support to the patient is not accepted; neither in our county nor in the whole world. Real DNAR decision only suggests not performing CPR. Next step should be determining the person making the DNAR decision. DNAR decision should be taken when the patient is having a cardiac arrest and needing CPR. This decision is too much important to be made by a single person. In our country, at CPR performing, ending and resuscitating, usually health givers are managing the relations between the families showing a paternalist approach. This paternalist approach is seriously criticized in developed countries and is slowly replaced with ethical attitudes involving the patient and his/her relatives (2). CPR decision should be made not just in arrest occasions but also regarding the underlying disease and the patient’s personal evaluation and current situation. Another important issue is the variations in health givers’ religious beliefs, occupations, ethnic features, and social status (3). In order to maintain a standard management, clinicians, medical ethic specialists, forensic medicine specialists, lawyers, sociologists, religion experts and representatives of all different culture groups should be involved to make a concrete decision (4).
Since DNAR term is not legitimately accepted in our country so it is not performed. However, this does not change the number of patients whom will not benefit from CPR performance. The ‘slow codes’ (showing inefficient resuscitative efforts initiatively) occurring in such occasions is not an appropriate method (1). This application is a moral burden for the decision maker. It results in ethical bias among health givers, misinterpretation and damages the saver-patient relationship (1). Additionally, it also raises the CPR incidence of the country and decreases the successful CPR rate (5). DNAR being fiercely debated among the world and it is not generally discussed in our country, yet.
Our aim in this study is to evaluate the role of DNAR in emergency theaters and to determine the practicability of DNAR term.