Ethical issues of do not resuscitate in cancer patients: A narrative review from a nursing perspective

This narrative review aims to examine the ethical issues of do not resuscitate order (DNR) in cancer patients from a nursing perspective. Keywords were obtained based on Medical Subject Headings with titles related to the topic of the article. The data was obtained by searching English keywords (cardiopulmonary resuscitation, cancer, dilemma, oncology) in the title and abstract of the PubMed, Scopus, and Web of Science databases without time limits to access published foreign studies. Also, to access published Persian studies, Iranian websites, including Scientific Information Database, Magiran, and Iranmedex scientific databases, were searched with equivalent Persian keywords. Also, based on the determined keywords, a free search was also conducted in the Google Scholar search engine. The study on the implementation of DNR orders by healthcare providers has been of interest to medical staff, patients, and their families in the past. The issue of choosing between life and death to reduce pain and suffering and the lack of facilities to treat patients in the last stages of the disease is one of the main reasons for making a DNR order, especially in cancer patients who are going through the last stages of their lives. In various studies, various aspects of the treatment staff’s and patients’ attitudes were examined, but the most attention is paid to factors such as the doctor’s moral competence, the patient’s independence, the quality of life, and adopting the right time for this order. In these studies, it has been shown that the DNR order is widely used in patients with advanced cancers. Therefore, managers and policymakers in the health field should provide a platform for training the medical care team, especially nurses, in the field of various aspects of the ethical competence of DNR and interaction with these patients and their families.