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Perspectives of interns and residents toward do-not-resuscitate policies in Saudi Arabia

Authors Amoudi A, Albar M, Bokhari A, Yahya S, Merdad A

Received 29 October 2015

Accepted for publication 18 December 2015

Published 14 March 2016 Volume 2016:7 Pages 165—170

DOI https://doi.org/10.2147/AMEP.S99441

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Shakila Srikumar

Peer reviewer comments 2

Editor who approved publication: Dr Anwarul Azim Majumder

Abdullah S Amoudi,1 Mohammed H Albar,2 Amjed M Bokhari,3 Sultan H Yahya,4 Anas A Merdad1

1Department of Internal Medicine, 2Department of Obstetrics and Gynecology, 3Department of Surgery, King Abdulaziz University Hospital, Jeddah, 4Department of Radiology, King Saud University Hospital, Riyadh, Kingdom of Saudi Arabia

Objective:
Do-not-resuscitate (DNR) orders in Saudi Arabia were first regulated by a fatwa on a national level in 1988, one that excludes the patient and their families from decision making. Although the core of this policy is taken up by all hospitals in Saudi Arabia, there is no homogeneity in implementation. Here, we appraise what interns and residents know of these policies and their attitudes toward DNR.
Methods: Interns and residents in four major hospitals in Jeddah, King Abdulaziz University Hospital, National Guard Hospital, King Fahad General Hospital, and King Fahad Armed Forces Hospital, were given a questionnaire in English with four blocks of questions.
Results: A total of 140 questionnaires were included in our study. From these questionnaires, we conclude a lack of familiarity with DNR's policies and the fatwa and also a lack of understanding when it comes to treating DNR-labeled patients. The majority opinion was to include the patient in the decision-making process who is excluded according to the fatwa. Participants considered patients' dignity, religious concerns, and legal concerns to be important in considering resuscitation.
Conclusion: We conclude a need to emphasize the issue of DNR and treatment of DNR patients in medical ethics classes in Saudi Arabia and put more effort to enact national DNR laws that include the patient in the decision-making process.

Keywords: passive euthanasia, Middle East, cross-sectional study

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