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Education And Debate For and against

Doctors should not discuss resuscitation with terminally ill patients

BMJ 2003; 327 doi: (Published 11 September 2003) Cite this as: BMJ 2003;327:615


  1. Irene J Higginson, head of department (
  1. 1 Department of Palliative Care and Policy, King's College London, Weston Education Centre, London SE5 9RJ

    Doctors in Britain are expected to attempt resuscitation unless patients have agreed do not resuscitate orders. If patients are terminally ill, is discussion of such orders harmful or helpful?

    Patients with chronic illness and cancer have special needs. Their treatment options are complex, are offered over longer periods of time because of improved survival, and have benefits and risks that are difficult to weigh. Terminally ill patients often have to make decisions about their final treatment after a protracted period of illness, investigation, and treatment. But this does not mean they don't want to be involved. Poor communication and information leads to poor patient satisfaction, symptom management, and compliance.13 New guidance on effective models of supportive and palliative cancer care suggests that effective training in communication can improve patient satisfaction and some outcomes. …

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