Doctors' Attitudes towards Do Not Resuscitate (DNR) Orderin Terminal Patients: A Qualitative Study

Background The success rate of Cardiopulmonary Resuscitation (CPR) in cardiac arrest in patients with terminal condition has been proven very small, less than 2%, but DNR order decision making in patients with such conditions is not easy for physicians. Many factors can affect the doctors’ attitude. Objective To study the attitudes of doctors towards the do-not-resuscitate (DNR) decision and the reasons behind their attitudes. Method A descriptive-qualitative research based on in-depth interview was conducted in a private hospital in Surabaya Indonesia. The subjects of the study were doctors who had taken care of patients with terminal conditions. Result A total of 16 doctors participated in the study, consists of men and women from various specialties, age variations, and length of time as doctors. Twelve participants agreed to issue DNR order to the terminal patients, so that the patient could die peacefully, in order to minimize the patient’s affliction, simplify other medical personnel’s tasks, and minimize the family burden. The reasons why participants did not agree to issue DNR order were because they did not dare to convey it to the patient, because they were worried that it would worsen the patient's condition, because they believed that doctors should help patients as much as possible and because they thought that in the local community it was not customary to discuss death issues with patients and families. Conclusion There are doctors who agree and disagree with issuing DNR orders to terminal patients. Each attitude has its own reasons according to ethical and moral considerations and previous experience. Keywords: doctors’ attitude, DNR order, terminal patient