Experiences of Iranian physicians regarding do not resuscitate: a directed-content analysis

One of the major advances in medicine has been the use of cardiopulmonary resuscitation (CPR) procedure since the 1960s in order to save human lives. This procedure has so far saved thousands of lives. Although CPR has helped to save lives, in some cases, it prolongs the process of dying, suffering, and pain in patients. This study was conducted to explain the experience of Iranian physicians regarding do not resuscitate order (DNR). This study was a directed qualitative content analysis which analyzed the perspective of 8 physicians on different aspects of DNR guidelines. Semi-structured, in-depth interview was used to collect data (35 to 60 minutes). First, literature review of 6 main categories, including clinical, patient and family, moral, legal, religious, and economic aspects, was carried out through content analysis. At the end of each session, interviews were transcribed verbatim. Then, the text was broken into the smallest meaningful unit (code) and the codes were classified into main categories. The codes were classified into 6 main categories, which were extracted from the literature. In the clinical domain 4 codes, in patient and family 3 codes, in moral domain 4 codes, in religious domain 3 codes, and in economic domain 1 code were extracted. According to the findings of this study, it can be said that Iranian physicians approve the DNR order as it provides dying patients with a dignified death. However, they do not issue DNR order due to the lack of legal and religious support. Nevertheless, if legislators and the Iranian jurisprudence pass a bill in this regard, physicians with the help of clinical guidelines can issue DNR order for dying patients who require it.