TY - JOUR
T1 - Legislating how critical care physicians discuss and implement do-not-resuscitate orders
AU - Bruce, Courtenay
AU - Bibler, Trevor
AU - Childress, Andrew
AU - Fedson, Savitri
N1 - Publisher Copyright:
© 2017
Copyright:
Copyright 2019 Elsevier B.V., All rights reserved.
PY - 2018/4
Y1 - 2018/4
N2 - A few weeks ago, Texas took an unprecedented position on unilateral DNRs by passing Senate Bill (SB) 11, which requires patient/surrogate consent for writing DNR orders. The motivation behind the bill was based on the drafters' beliefs that physicians frequently write unilateral DNR orders. SB 11, however, does not stop at requiring physicians to seek consent for DNR orders. Instead, the legislation uncharacteristically exceeds what is typically within the scope and role boundaries for lawmakers by legislating how physicians discuss and implement DNR orders. We contend that this bill is ethically problematic and will have far-reaching, negative consequences that will affect how critical care medicine is practiced. In what follows, we describe how proponents' arguments rely on several ethical assumptions, and we describe potential negative impacts stemming from this legislation. Finally, we offer an alternative approach that would mitigate proponents' concerns. We believe SB 11 and our analytic deconstruction of it should serve as “lessons learned” for other states considering similar legislation.
AB - A few weeks ago, Texas took an unprecedented position on unilateral DNRs by passing Senate Bill (SB) 11, which requires patient/surrogate consent for writing DNR orders. The motivation behind the bill was based on the drafters' beliefs that physicians frequently write unilateral DNR orders. SB 11, however, does not stop at requiring physicians to seek consent for DNR orders. Instead, the legislation uncharacteristically exceeds what is typically within the scope and role boundaries for lawmakers by legislating how physicians discuss and implement DNR orders. We contend that this bill is ethically problematic and will have far-reaching, negative consequences that will affect how critical care medicine is practiced. In what follows, we describe how proponents' arguments rely on several ethical assumptions, and we describe potential negative impacts stemming from this legislation. Finally, we offer an alternative approach that would mitigate proponents' concerns. We believe SB 11 and our analytic deconstruction of it should serve as “lessons learned” for other states considering similar legislation.
UR - http://www.scopus.com/inward/record.url?scp=85039041303&partnerID=8YFLogxK
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U2 - 10.1016/j.jcrc.2017.12.010
DO - 10.1016/j.jcrc.2017.12.010
M3 - Editorial
C2 - 29287932
AN - SCOPUS:85039041303
SN - 0883-9441
VL - 44
SP - 459
EP - 461
JO - Journal of Critical Care
JF - Journal of Critical Care
ER -