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In their article, Boyd et al¹ suggest that "older patients are significantly more likely than younger patients to have do-not-resuscitate (DNR) orders written," and conclude that this association represents "age discrimination" against older patients. However, in their letter, Rosenfeld and Wenger² state that a "higher rate of DNR orders represents provider responsiveness to elderly patients' own values and preferences." We recently carried out a small study in our hospital—a community teaching hospital—to address this issue. Our data strongly suggest that the patient's preference, rather than age discrimination, is a decisive factor in obtaining DNR orders for elderly patients admitted to intensive care units (ICUs).

We reviewed a total of 214 adult patients who were admitted to either medical or surgical ICUs in June of 1996. Patients were divided into 4 subgroups: 18 to 64 years, 65 to 74 years, 75 to 84 years, and 85 years and older. Similar to . . . [Full Text of this Article]