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do not resuscitate : ウィキペディア英語版
do not resuscitate

Do not resuscitate (DNR), or no code, is a legal order written either in the hospital or on a legal form to withhold cardiopulmonary resuscitation (CPR) or advanced cardiac life support (ACLS), in respect of the wishes of a patient in case their heart were to stop or they were to stop breathing. "No code" is a reference to the use of "code" as jargon for "calling in a Code Blue" to alert a hospital's resuscitation team. The DNR request is usually made by the patient or health care power of attorney and allows the medical teams taking care of them to respect their wishes. In the health care community, allow natural death (AND), is a term that is quickly gaining favor as it focuses on what is being done, not what is being avoided. Some criticize the term "do not resuscitate" because it sounds as if something important is being withheld, while research shows that only about 5% of patients who require CPR outside the hospital and only 15% of patients who require CPR while in the hospital survive.〔PMID 17174021〕 Patients who are elderly, are living in nursing homes, have multiple medical problems, or who have advanced cancer are much less likely to survive.
A DNR does not affect any treatment other than that which would require intubation or CPR. Patients who are DNR can continue to get chemotherapy, antibiotics, dialysis, or any other appropriate treatments.
== Alternative terms ==
Other terms and abbreviations for this order are used in different countries. ''DNR'' (Do Not Resuscitate) is a common abbreviation in the United States, Canada and the United Kingdom. It may be clarified in some regions with the addition of ''DNI'' (Do Not Intubate), although in some hospitals ''DNR'' alone will imply no intubation. Clinically, the vast majority of people requiring resuscitation will require intubation, making a DNI alone problematic.
Some areas of the United States and the United Kingdom include the letter A, as in ''DNAR'', to clarify "Do Not ''Attempt'' Resuscitation." This alteration is so that it is not presumed by the patient or family that an attempt at resuscitation will be successful. Since the term DNR implies the omission of action, and therefore "giving up", some have advocated for these orders to be retermed ''Allow Natural Death''.〔(Alternative to "DNR" Designation: "Allow Natural Death" - Making Sense in the Health Care Industry ).〕 New Zealand and Australia, and some hospitals in the UK, use the term ''NFR'' or ''Not For Resuscitation''. Typically these abbreviations are not punctuated, e.g., ''DNR'' rather than ''D.N.R.''
Another synonymous term is "''not to be resuscitated''" (''NTBR'').〔Vincent JL, Van Vooren JP. ((Not to Be Resuscitated) in 10 questions ). Rev Med Brux. 2002 Dec;23(6):497-9. French. PubMed PMID 12584945.〕
Until recently in the UK it was common to write "Not for 222" or conversationally, "Not for twos." This was implicitly a hospital DNR order, where 222 (or similar) is the hospital telephone number for the emergency resuscitation or crash team.

抄文引用元・出典: フリー百科事典『 ウィキペディア(Wikipedia)
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