Do-Not-Resuscitate Orders

This article provides  a guide for clinicians on how to “… improve the quality of code status converesations and enhance end-of-life care planning.”    Included is a concise summary of the epidemiology of cardiopulmonary resuscitation  and do-not-resuscitate orders.    The authors present a table that summarizes guidelines for the code status discussion.  Three illustrative scenarios demonstrate how code status is applied in various situations.

Loertscher L and others.  Cardiopulmonary Resuscitation and Do-Not-Resuscitate Orders:  A Guide for Clinicians.  American Journal of Medicine 2010 Jan.; 123(1):123-129.   PMID 20102982

Spiritual Needs of Cancer Patients Near Death

The investigators in this study surveyed patients to examine the associations of spiritual care on patient well-being just before death.  An extensive analysis of the results provided evidence for the influence of spiritual care on better patient quality of life near death.   The investigators state:  “… spiritual care from the medical system seems to have important ramifications for patients at the EoL–helping them transition to hospice and improving their well-being near death.  Furthermore, among high religious coping patients, spiritual support seems to reduce their risk of receiving aggressive interventions at EoL.”

Balboni TA and others.  Provision of Spiritual Care to Patients With Advanced Cancer: Associations With Medical Care and Quality of Life Near Death.  Journal of Clinical Oncology 2009; published ahead of print on December 14, 2009.  20008625