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首页> 外文期刊>Current opinion in anaesthesiology >Should do-not-resuscitate orders be suspended for surgical cases?
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Should do-not-resuscitate orders be suspended for surgical cases?

机译：手术病例是否应该中止不复活的命令？

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There are significant misunderstandings about the management of perioperative do-not-resuscitate orders. This paper reviews some of the difficulties generated by the halting acceptance and inconsistent implementation of an ethically appropriate perioperative do-not-resuscitate policy that mandates reconsideration of existing do-not-resuscitate orders. It also offers strategies for empowerment of such a policy.Recent advances in the ethical practice of anesthesiology have centered on determining and correcting why perioperative do-not-resuscitate policies are poorly accepted, and how to establish a hospital-wide adherence to such policies. Barriers to ethically appropriate application of perioperative do-not-resuscitate orders include differing values and misunderstandings between physicians and their patients - and also between anesthesiologists and other physicians - as well as medicolegal concerns. Policies should be designed and implemented at the level of the healthcare institution, and they must be sufficiently flexible to permit the tailoring of the perioperative do-not-resuscitate order to the autonomous choice of the patient. Such policies should state unambiguously that existing do-not-resuscitate orders are to be reevaluated, delineate responsibilities for reconsidering the do-not-resuscitate order, state available options, define necessary documentation, and list resources for help.A well written perioperative do-not-resuscitate policy is essential for surmounting obstacles to a well functioning perioperative do-not-resuscitate system.
机译：关于围手术期不要复苏命令的处理存在重大误解。本文回顾了由于停止接受和不一致执行符合道德规范的围手术期“不复活”政策而产生的一些困难，该政策要求重新考虑现有的“不复活”命令。它还为增强这种政策提供了策略。麻醉学的伦理实践的最新进展集中于确定和纠正为什么围手术期不复苏的政策被人们接受的程度不佳，以及如何建立全院对此类政策的依从性。在伦理上适当应用围手术期“不要复苏”命令的障碍包括医师与其患者之间以及麻醉医师与其他医师之间存在不同的价值观和误解，以及法医问题。应在医疗机构一级设计和实施策略，并且这些策略必须足够灵活，以允许根据患者的自主选择量身定制围手术期“不复活”的顺序。此类政策应明确声明应重新评估现有的请勿重做命令，划定重新考虑请勿重做命令的责任，陈述可用选项，定义必要的文档并列出帮助资源。不复苏政策对于克服运转良好的围手术期不复苏系统的障碍至关重要。

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