For this reason, overall statistics show a limited short and even worse long-term outcome for patients undergoing resuscitation. Despite these poor outcomes, resuscitation is considered the standard of care for patients. In general, in an emergency a patient is presumed to give consent to medical standard care unless they have previously stated an objection. To be precise, resuscitation is the successful outcome of an attempt to resuscitate. This right takes precedence over other considerations such as the likelihood of success, other family member s desires, or physician preference.
Many hospitals have policies that patients are asked about their preferences on admission.
It can be held that physicians have an obligation to discuss DNAR issues with patients based on the principles of beneficence and justice. Beneficence would hold that it is in the patient s best interest to have the opportunity to make their wishes known, and justice would hold that since some patients have the opportunity, all should. Justice and beneficence also would support a patient s right to refuse a DNAR status and thus have access to a therapy that might be ineffective and costly regardless of their ability to pay the costs. When patients are not competent, decisions about resuscitation are made by others. If none has been designated, the courts may appoint a surrogate.