The do not resuscitate controversy.

"Mother had 'Do Not Attempt to Resuscitate' on her notes. I did not know. It was not discussed." Lisa McMurdie is upset that no-one discussed DNAR, but how common is this? Shah Ibrahim says DNAR is common with the old in UK, but also with Blacks, Aids patients and those who do not speak English in USA! Some patients may not want to talk about dying or resuscitation. Resuscitation, involving defibrillation and intubation, can be very unpleasant, painful, and the outcome may only be 40-50% immediate survival, and only 10-15% may ever leave hospital anyway. Patients may not know about resuscitation or their chances of survival. The prognosis may change while the patient is in hospital. Ann Donald says death is seen as failure, when in fact it may be the best outcome. There is little research on quality of life after resuscitation. Doctors cannot be sure which cases are terminal, but those with other complications are most likely to die. Communication about DNAR can be very difficult for doctors, patients and relatives.