ABSTRACT

DO NOT RESUSCITATE ORDER You are the medical senior house officer (SHO) on-call. Mr Smith, aged 78, has advanced metastatic cancer of the bladder. He was admitted with a chest infection, has been on the ward for 2 days, and has been too poorly to communicate clearly until now. The team has indicated in the medical notes that his prognosis is weeks rather than months, and that in view of his significant co-existing ischaemic heart disease, cardiopulmonary resuscitation is inappropriate. However, they have not been able to discuss this with him, and a ‘do not resuscitate order’ has not been signed. Today his symptoms are well controlled and he appears alert. The nurse in charge has asked you to discuss his resuscitation status with him.