patient were intubated for the resuscitation but did not regain consciousness
for 48 hours, is it ethical to withdraw mechanical ventilation at this time?
It is considered appropriate to withdraw care
in the postoperative period if continued care is unlikely to achieve the
desired goals of the patient. Since it is more ethically challenging to
withhold therapy not knowing if an event is temporary, it is suggested that
therapy be initi-ated. Once a trial and assessment are performed, an
evalu-ation at a later time may determine that withdrawal of that therapy would
be more in line with the patientâ€™s wishes.
Despite the published guidelines suggesting the
re-evaluation of DNR for the perioperative period, many practitioners still
feel uncomfortable doing so for ethical and personal reasons. Others may find
it too difficult to re-evaluate and customize a DNR order for the perioperative
period, especially if the anesthesiologist is not comfortable interpreting the