Ethical implications of terminally ill and the current state of Do Not Resuscitate orders

Every human being needs to live with no suffering and to survive a satisfactory quality of life, however in cases of terminal illness or when one is bedridden with machines to maintain organ functions; the dilemma of the decision is arising. Yet, patients may put healthcare givers in an ethical debate by refusing to obtain care or treatment, regardless of that patients reserve the privilege patients to do so. This review has attempted to investigate the current debate regarding the DNR orders, discussing the rights of incurably ill patients decided on rejecting medical care apart from the different legitimate and ethical consequences concerning this fussy issue, giving a close picture of DNR in Egyptian Medical Practice and the Middle East. Numerous publications agreed with terminally ill patients in their right to allow the DNR order for them to die in peace. Furthermore, in many cases CPR may not lead to direct clinical benefits as the resuscitation could fail or result in complications, extending the suffering without treating the original disease. DNR should be considered particularly with patients who have worn out all other sorts of therapy modalities where there are multi-organ failure and no hope for a cure. The concept of DNR may seem cruel and intolerable for the patient and his family. The authors strongly believe that it would be more appropriate if the wording is changed from "Do Not Resuscitate" to "Allow Natural Death." Keywords: Do Not Resuscitate; Terminally ill; Cardiopulmonary Resuscitation; Allowed Natural Death; Ethics