• Mary P Henman.
• Meriter Hospital, Madison, Wisconsin.
• J Emerg Med. 2017 Jan 1; 52 (1): 117-120.

BackgroundA suicidal person with a do-not-resuscitate (DNR) order presents an ethical dilemma to the emergency physician. Many believe that suicide is an irrational action, and therefore, all suicide attempts must be treated. Others believe a DNR order should be respected even in the setting of a suicide attempt.Case ReportAn elderly woman with a known terminal illness presented to the emergency department after a suspected suicide attempt. She had a DNR order during her previous hospitalization. The emergency physician felt obligated to intubate the woman despite his recognition that she was terminally ill.DiscussionReasons to both honor and not honor a DNR order after a suicide attempt are reviewed.ConclusionNot all patients who attempt suicide are necessarily incapable of making a rational decision about their health care. In some cases it may be appropriate to withhold resuscitation attempts in suicidal patients who have a preexisting DNR order. Institutional policies are needed to provide guidance in this situation.Copyright © 2016 Elsevier Inc. All rights reserved.

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