Ethics of DNACPR Without Patient Consent

Doctor, Should We Talk About Saving My Life? Is It Ethically Justifiable to Decide on a ‘Do Not Resuscitate’ Order Without Consulting the Patient?

Adesh Ajmani

‘Do not attempt cardiopulmonary resuscitation’ (DNACPR) exists when clinicians make a decision not to perform cardiopulmonary resuscitation (CPR). ‘Deciding when to withhold CPR is a delicate issue, as is the question of whether the patient ought always to be involved in the decision-making process.’ However, at times it may be ethically justifiable to decide for DNACPR, without discussing with the patient, an argument which will be illustrated in this article. This paper seeks to address this debate by initially reviewing the role of paternalism juxtaposed against autonomy, before then moving to consider the doctors role of beneficence and non-maleficence, and finally concluding on justice and the notion of therapeutic privilege.

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