Shifting paradigm: From "No Code" and "Do-Not-Resuscitate" to "Goals of Care" policies

Policies addressing limitations of medical therapy in patients with advanced medical conditions are typically referred to as Code Status (No Code) policies or Do-Not-Resuscitate (DNR) status polices. Inconsistencies in implementation, understanding, decision-making, communication and management of N...

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Bibliographic Details
Published in:Annals of thoracic medicine 2018-04, Vol.13 (2), p.67-71
Main Authors: Arabi, Yaseen, Al-Sayyari, Abdulla, Al Moamary, Mohamed
Format: Article
Language:English
Subjects:
Analysis
Cardiopulmonary resuscitation
CPR
critical care
Decision making
Do-not-resuscitate orders
Ethics
Health policy
Health sciences
Hospitals
Intensive care
Laws, regulations and rules
Medicine
Mortality
Ostomy
palliative care
patient comfort
Patients
Trauma
Verbal communication
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Summary:Policies addressing limitations of medical therapy in patients with advanced medical conditions are typically referred to as Code Status (No Code) policies or Do-Not-Resuscitate (DNR) status polices. Inconsistencies in implementation, understanding, decision-making, communication and management of No Code or DNR orders have led to delivery of poorer care to some patients. Several experts have called for a change in the current approach. The new approach, Goals of Care paradigm, aims to contextualize the decisions about resuscitation and advanced life support within the overall plan of care, focusing on choices of treatments to be given rather than specifically on treatments not to be given. Adopting "Goals of Care" paradigm is a big step forward on the journey for optimizing the care for patients with advanced medical conditions; a journey that requires collaborative approach and is of high importance for patients, community and healthcare systems.
ISSN:1817-1737
1998-3557
DOI:10.4103/atm.ATM_393_17