Do Not Resuscitate Orders in Pediatric Patients
Ethical Issues in Healthcare

Abstract
Children with terminal illnesses frequently have do not resuscitate orders. Dealing with dying children, and letting them die without major intervention can be hard issues for nursing and other health care professionals to cope with, and can cause an internal ethical dilemma. The seven nursing ethical principles are discussed in regards to do not resuscitate orders, and ethical theory is applied. The ethical dilemma faced by nurses with do not resuscitate order is discussed, and how to resolve it.

Do Not Resuscitate Orders in Pediatric Patients
Children throughout the United States are diagnosed with terminal diseases daily. Once medical
When a patient and family decide on a do not resuscitate order, nurses need to understand that do not resuscitate is not the plan of care (Murphy & Price, 2007). A do not resuscitate order only addresses whether or not to start cardiopulmonary resuscitation. The patient and/or family have decided that being resuscitated is not in the best interest of the child, but many other interventions are still available to the patient. Nurses and other staff members have to respect the autonomous decision of the patient and family. The nursing ethical principle of justice involves giving fair and equal care to all patients (Burkhardt & Nathaniel, 2002). A child with a do not resuscitate order should be cared for comparatively like other children on the unit who are a full code. Therapies, activities, and other nursing measures apply to the child with a do not resuscitate order the same as a full code child (Wright, Forbat, Knighting, & Kearney, 2008).
Confidentiality, Veracity, and Fidelity
Whether a child has a do not resuscitate order or not, confidentiality is given to every patient. It is not only an ethical principle nurses must adhere to; it is also a violation of the Health Insurance Portability and Accountability Act. Veracity is the duty to tell the truth (Burkhardt & Nathaniel, 2002). If parents and/or the child have questions about what