ArticleBMC medical ethics2020
The ethics of DNR-decisions in oncology and hematology care: a qualitative study.
Article in BMC medical ethics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 21 citations in OpenAlex.
- A Qualitative Research Survey on Cardiologist's Ethical Stance in Cases of Moral Dilemmas in Cardiology Clinics.Health care analysis : HCA : journal of health philosophy and policy · 2026Article
- Governing Patient-Facing AI-Generated Video in Digital Health: A Risk-and-Ethics Matrix for Deployment, Monitoring, and Change Control.Journal of medical Internet research · 2026Article
- Reimagining resuscitation ethics: a narrative review and emergent ethical pathways model.Resuscitation plus · 2026Review
- Ethical challenges in end-of-life cancer care: a qualitative study among health-care providers in Iran.BMC palliative care · 2026Article
- Understanding challenges and barriers to quality end-of-life care for patients with hematologic malignancies: a GIMEMA survey.Annals of hematology · 2025Article
- Development and Validation of a Case-Based Survey Assessing Ethical Decision-Making in Prehospital Resuscitation.Healthcare (Basel, Switzerland) · 2025Article
- Do not resuscitate orders and limitation of therapeutic effort: Ethical challenges in healthcare teams in Chile.Salud colectiva · 2024Article
- Public Attitude towards Implementing DNAR and a Stance on Pediatric DNAR in Poland-A Prospective Survey Study.Journal of clinical medicine · 2024Article
- Exploring what is reasonable: uncovering moral reasoning of vascular surgeons in daily practice.BMC medical ethics · 2023Article
- Moral distress among critical care nurses when excecuting do-not-resuscitate (DNR) orders in a public critical care unit in Gauteng.The Southern African journal of critical care : the official journal of the Critical Care Society · 2023Article
- "Do not resuscitate" order and end-of-life treatment in a cohort of deceased in a Norwegian University Hospital.Acta anaesthesiologica Scandinavica · 2022Observational
- Factors influencing terminal cancer patients' autonomous DNR decision: a longitudinal statutory document and clinical database study.BMC palliative care · 2022Article
- Prognostic decision-making about imminent death within multidisciplinary teams: a scoping review.BMJ open · 2022Article
- Investigating Key Factors Related to the Decision of a Do-Not-Resuscitate Consent.International journal of environmental research and public health · 2021Article
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn cancer care, do not resuscitate (DNR) orders are common in the terminal phase of the illness, which implies that the responsible physician in advance decides that in case of a cardiac arrest neither basic nor advanced Coronary Pulmonary Rescue should be performed. Swedish regulations prescribe that DNR decisions should be made by the responsible physician, preferably in co-operation with members of the team. If possible, the patient should consent, and significant others should be informed of the decision. Previous studies have shown that physicians and nurses can experience ethical dilemmas in relation to DNR decisions, but knowledge about what ethical reasoning they perform is lacking. Therefore, the aim was to describe and explore what ethical reasoning physicians and nurses apply in relation to DNR-decisions in oncology and hematology care.
methodsA qualitative, descriptive and explorative design was used, based on 287 free-text comments in a study-specific questionnaire, answered by 216 physicians and nurses working in 16 oncology and hematology wards in Sweden. Comments were given by 89 participants.
resultsThe participants applied a situation-based ethical reasoning in relation to DNR-decisions. The reasons given for this were both deontological and utilitarian in kind. Also, expressions of care ethics were found in the material. Universal rules or guidelines were seen as problematic. Concerning the importance of the subject, nurses to a higher extent underlined the importance of discussing DNR-situations, while physicians described DNR-decisions as over-investigated and not such a big issue in their daily work.
conclusionThe study revealed that DNR-decisions in oncology and hematology care gave rise to ethical considerations. Important ethical values described by the participants were to avoid doing harm and to secure a peaceful and "natural" death with dignity for their dying patients. A preference for the expression "allow for natural death" instead of the traditional term "do not resuscitate" was found in the material.
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