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Response to: increasing use of DNR orders in the elderly worldwide: whose choice is it
  1. A D Lawson
  1. Royal Berkshire Hospital, London Road, Reading RG1 5AN, UK;

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    I read Dr Cherniack’s article regarding do not resuscitate (DNR) orders with interest.1 One of the problems with DNR orders is the patients’ assumption that if there is no DNR order they will survive resuscitative efforts. This of course is far from the truth. In my hospital these orders have been modified to “do not attempt to resuscitate” orders. One cannot be truly autonomous without being informed. Long term survival, as measured only by being alive, following inhouse cardiac arrest, is about 15% over all age groups.2 In sick elderly patients over 70 years of age who survive a cardiac arrest, the subsequent hospital mortality approaches 100%. This fact, and concerns about harm, influence physicians’ attitudes, …

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