DO not REsuscitate orders by people with Suicidal ideations (DORES)

People with suicidal ideations seem to be increasingly drafting Do-Not-Resuscitate (DNR) orders, which often lead to challenging and morally distressing situations. When cardiopulmonary resuscitation (CPR) is successfully performed, patients may experience residual complaints and feel that their autonomy has been violated. Conversely, following a DNR order drafted during a transient suicidal state that does not reflect the true wishes of the patient, can result in preventable loss of life, which is a tragedy in itself and may also be harmful to relatives.

Research on this topic is limited, and there are currently no guidelines or clear policies to guide these encounters. The objective of this research project is to better understand people with suicidal ideations who draft a DNR order. Aiming to improve the care they receive.

To achieve this, we aim to learn these people’s characteristics. Why do they not want to be resuscitated? And we aim to learn if the DNR order represents a competent decision and how this decision develops over time. Participants will be sent an online survey and after approximately 12 months a second survey will be sent to reassess their situation. In addition, all patient-participants will be asked to take part in the MacCAT-T interview. In this interview we test decision-making competence regarding the DNR order.

Since relatives and physicians also play a crucial role in the care of patients that may need CPR after a suicide attempt, the participants’ relatives and general practitioners (GPs) are asked to complete a questionnaire. Furthermore, some patients, relatives and GPs will be invited for in-depth interviews.
Inclusion of participants will start in the coming months.