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Do-Not-Resuscitate Orders in Suicide Attempts

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Do-Not-Resuscitate Orders in Suicide Attempts
Nursing 410

Introduction
The National Institute of Mental Health (NIMH) has published a fact sheet of statistics on suicide in the United States. In 2007, it is reported that suicide was the tenth leading cause of death. Furthermore, for every suicide committed, eleven were attempted. A total of 34,598 deaths occurred from suicide with an overall rate of 11.3 suicide deaths per 100,000 people. (NIMH, 2010). Risk factors were also noted on this report and listed “depression and other mental disorders, or a substance abuse disorder (often in combination with other mental disorders). More than ninety percent of people who die by suicide have these risk factors (NIMH, 2010).”
Since the
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A patient may give clues with or without realizing they have done so; therefore, the nurse needs to be cognizant of such and relay the information to the physician. Even if the patient has a terminal illness and has decided to end his life, the nurse who has picked up on this decision still needs to relay this information to the physician for it to be explored further.
Ethical Implications
An ethical dilemma arises when a patient who has an advance directive and/or a DNR in place attempts suicide. “The idea of saving people vs. allowing people to die or commit suicide is at the very essence of one of the most debated and controversial dilemmas today. As long as there is difficulty in determining rationality in suicide, this controversy will remain (Butts & Rich, 2008).” Not only do the principles of autonomy, nonmaleficence, and beneficence collide with one another, but legal, religious, and/or economic values are also impacted (Cook, Pan, Silverman, & Soltys, 2010). According to Butts and Rich, “rational suicide is a self-slaying based on reasoned choice and categorized as voluntary active euthanasia and that individuals who contemplate rational suicide have a realistic assessment of life circumstances, are free from severe emotional distress, and have a motivation that would seem understandable to most uninvolved people in their community.” Contrary to that statement is the finding in the various articles read indicating that individuals who
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