Table 3 Doctor responses to a series of general statements

Since anesthesia for surgery basically represents a resuscitative effort (endotracheal intubation, pressor support, etc.), DNR (“Do not Resuscitate”) status makes no logical sense in the context of a surgical procedure requiring an anesthetic.

The delivery of every anesthetic likely involves depression and manipulation of the cardiac and respiratory systems and the anesthesia team must be permitted to use all their skills to provide the best possible anesthetic outcome for the patient regardless of preoperative DNR status.

Since patients do not have the knowledge to adequately appreciate the idiosyncrasies involved in the practice of medicine, physicians should independently evaluate what is in the best interest of patients regardless of the contents of an advance directive with regard to perioperative DNR status.

DNR status should be respected during the intraoperative (while under the care of the anesthesia team to include the post anesthesia care unit) course because resuscitative issues are not the private preserve of health care providers but rather based on the patient’s own value system.

DNR status should be disregarded during the perioperative phase of patient care because there is increased likelihood of successful resuscitation, regardless of the precipitating event, in the highly monitored setting of the operating room.

Since it is difficult to distinguish between cardiorespiratory arrest that may occur spontaneously and that which occurs due to therapeutic intervention under anesthesia, DNR status should be disregarded during a patient’s perioperative course.

If the patient has sufficient capacity to consent to the risks and benefits intrinsic to surgery and anesthesia, they have sufficient capacity to refuse or agree to attempts at resuscitation resulting from an intraoperative cardiopulmonary arrest.