IS LIVING WITH A FATAL DISEASE WORTH LIVING?AN ETHICAL DILEMMA IN DO-NOT-RESUSCITATE (DNR) DECISION-MAKING
DOI:
https://doi.org/10.71146/kjmr886Keywords:
DNR, Ethical dilemma, CPR, Futility, Patient autonomy, Decision-making, Communication, Islamic perspectiveAbstract
Patients with poor prognosis are often considered for do-not-resuscitate (DNR) orders, raising complex ethical, clinical, and communication challenges. This paper explores how DNR decisions are made, implemented, and communicated within healthcare settings, particularly in oncology care. The primary ethical responsibility of healthcare professionals is to maximize patient benefit while minimizing harm. However, conflicts frequently arise between patient autonomy, family wishes, and clinical judgment.
This paper presents a case of a young patient with metastatic cancer where disagreement occurred between the healthcare team and family regarding DNR status. Ethical principles, including autonomy, beneficence, and non-maleficence, are critically analyzed alongside religious perspectives, particularly within the Islamic context. The discussion emphasizes that while patient autonomy is central, futile interventions such as cardiopulmonary resuscitation (CPR) may be ethically withheld when deemed non-beneficial by clinicians. The paper highlights the need for structured policies, improved communication, and culturally sensitive approaches to DNR decision-making.
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References
Burns JP, Truog RD. The DNR order after 40 years. N Engl J Med 2016;375(6):504-506
M Takrouri, T Halwani. An Islamic medical and legal prospective of do not resuscitate order in critical care medicine. The Internet Journal of Health 2007;7(1):1-7.
Saiyad S. Do not resuscitate: A case study from the Islamic viewpoint. JIMA. 2009;41:109-113.
Jan MM. The decision of do not resuscitate in pediatric practice. Saudi Med J 2011;32: 115-122.
Breault JL. DNR, DNAR, or AND? Is language important? Ochsner J 2011;11(4):302-306.
Hussein GM, Alkabba AF, Kasule OH. Module 9. In Ware, J., &Kattan, T. (Eds.), Professionalism and ethics handbook for residents (PEHR): A practical guide (p.107). Riyadh: Saudi Commission for Health Specialties, 2015.
Gouda A, Al-Jabbary A, Fong L. Compliance with DNR policy in a tertiary care center in Saudi Arabia. Intensive Care Med 2010;36(12):2149-2153.
Sahih Al-Bukhari. Hadith no 575.
Permanent Committee for Scholarly Research and Ifta. Ruling on resuscitating the patient if he is dead, his health condition is not fit for resuscitation or his disease is incurable. Fatwa number 12086, 1989. http://www.alifta.net/Fatawa/FatawaChapters.aspx?View=Page&PageID=299&PageNo=1&Book ID=17. Accessed February 14, 2016.
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Copyright (c) 2026 Tariq Ullah, Mr. Adnan Yaqoob, Dr Muhamad Afzal (Author)
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