Development of Do Not Resuscitation rules and ethical dilemmas encountered

ABSTRACT Development of Do Not Resuscitation Rules and Ethical Dilemmas Encountered Aim: This study was conducted to determine the knowledge of anesthesiologists and anesthesia assistants working in the ICU (Intensive Care Unit) about the development of DNR (Do Not Resuscitation) rules and the ethical dilemmas encountered. Material Method: The study was planned as a cross-sectional and descriptive research type. The research was conducted by face-to-face interviews with Anesthesiology and Reanimation Physicians with an 18-question survey form prepared by researcher and ethicists. The research will take the opinions of Anesthesiology and Reanimation Physicians working at MEAH (Malatya Training and Research Hospital) and offer solutions to ethical dilemmas that DNR practice may involve, legal regulations in Turkey and ethical problems. In the study, an attempt was made to reach the entire population (20 people). Pearson chi-square test and Fisher's exact chi-square test were used in statistical analyses. In the statistical analysis applied, a p value of <0.05 was considered statistically significant. All analyzes were performed using IBM SPSS Statistics 26.0. Results: No statistically significant results were found in the age comparisons of the anesthesiologists and anesthesia assistants working in the MEAH ICU in the survey form, according to p < 0.05. In gender comparison, p<0.05 value is considered statistically significant; If DNR was legal, should it be performed if it was preferred by the patient due to the patient's right to autonomy? To the question (p=0.028), women answer yes and men answer no. In the comparison of anesthesiologists and their assistants, the answer to the statement "I do not apply DNR to my current patients, even if it is legal, even if other patients require ICU" (p=0.049) is answered by anesthesiologists, but anesthesia assistants say I do. When career years were compared, no statistically significant results were found according to p<0.05. No significant statistical result could be reached in the answers given according to the years of working in intensive care. Conclusion: In the survey applied to the anesthesiologists and anesthesia assistants who participated in our study, it was concluded that all employees knew the meaning of DNR, but they could not reach a clear consensus about the application method and application time and experienced an ethical dilemma. The fact that DNR is not legal in our country and the way DNR is implemented is not clarified by law shows that employees respond according to their own ethical perception and experience. Keywords: Do Not Resuscitation, Do Not Resuscitation rules, laws in Turkey, ethical dilemmas, Anesthesiology and Reanimation physicians