Causes of emergency ambulance transport in terminal cancer patients with do not attempt resuscitation (DNAR) decisions

Abstract

Purpose : To determine the reasons why terminal cancer patients with do not attempt resuscitation (DNAR) decisions require emergency ambulance transport.
Method : We interviewed 19 paramedics and analyzed their responses.
Result : The reasons why terminal cancer patients who have expressed their wishes for DNAR are taken by ambulance to a hospital include : lack of a legally valid system regarding DNAR ; inadequate knowledge regarding ambulance operations ; lack of medical support for death with DNAR decisions ; inadequate systems for such care in nursing homes ; overreliance on paramedics in emergency situations ; family members' wish to avoid death at home and ; panic and unpreparedness of the family members in the event of an emergency.
Conclusion : We found that against a background of an inadequate social and legal framework for patients with DNAR decisions, such patients were taken by ambulance to hospitals due to a lack of medical support and familys' lack of understanding of DNAR.