Citation

Henman MP. J. Emerg. Med. 2016; 52(1): 117-120.

Affiliation

Meriter Hospital, Madison, Wisconsin.

Copyright

(Copyright © 2016, Elsevier Publishing)

DOI

10.1016/j.jemermed.2016.09.004

PMID

27751701

Abstract

BACKGROUND: A suicidal person with a do-not-resuscitate (DNR) order presents an ethical dilemma to the emergency physician. Many believe that suicide is an irrational action, and therefore, all suicide attempts must be treated. Others believe a DNR order should be respected even in the setting of a suicide attempt. CASE REPORT: An elderly woman with a known terminal illness presented to the emergency department after a suspected suicide attempt. She had a DNR order during her previous hospitalization. The emergency physician felt obligated to intubate the woman despite his recognition that she was terminally ill.

DISCUSSION: Reasons to both honor and not honor a DNR order after a suicide attempt are reviewed.

CONCLUSION: Not all patients who attempt suicide are necessarily incapable of making a rational decision about their health care. In some cases it may be appropriate to withhold resuscitation attempts in suicidal patients who have a preexisting DNR order. Institutional policies are needed to provide guidance in this situation.

Copyright © 2016 Elsevier Inc. All rights reserved.

Language: en