Some treatment-withholding implications of no-code orders in an academic hospital

Crit Care Med. 1984 Oct;12(10):879-81. doi: 10.1097/00003246-198410000-00009.

Abstract

To identify treatment-withholding intentions for 56 VA medicine inpatients who received a no-code order, 31 resident physicians who wrote the orders completed a checklist on which they indicated the interventions they intended to withhold from each patient. Review of patients' charts indicated that 24 (43%) contained no documentation of treatment limitation plans beyond the no-code order. To identify the general interpretations of no-code orders, "cross-covering" physicians indicated on a questionnaire the likelihood that they would withhold specific interventions from patients they were covering who had received a no-code order. Both the intention and interpretation of no-code orders were characterized by variability, and interpretation of the orders was characterized by uncertainty as well. Because of these discrepancies, we suggest a no-code order which provides greater specificity for individual patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Documentation / standards
  • Hospital Bed Capacity, 300 to 499
  • Hospitals, Veterans
  • Humans
  • Internship and Residency
  • Medical Records / standards*
  • Oregon
  • Resuscitation / standards*
  • Surveys and Questionnaires
  • Terminal Care / standards*
  • Withholding Treatment