Resuscitation and Ethics: How to Deal with the "Do not Resuscitate Order"?

Resuscitation has the ability to reverse premature death but it can also prolong terminal illness, increase discomfort, and consume resources. Do Not Resuscitate (DNR) Order and Advance Directives (ADs) are still a debated issue in critical care. Worldwide there is a variety of policies, attitudes, and beliefs that are different among countries. It is well known about the variety of thoughts and religious thinking in the community and this is what justify the different ethical principles and a missing common law. To face the “end of care” issue and to achieve a consensus we believe in the priority of continuing education and training programs for health care professionals. Moving up the reflection on ethical values and principles useful to understand definition of medical professionalism, it could be possible to undertake the right way to avoid futile and aggressive care. To improve the attitude about DNR order it will be necessary to achieve several goals such as: increasing communication, consensus on law, increasing trust among patient and health care system, improving standards and quality of care, to respect patient’s will and family’s role.