DNR Orders in the Operating Room

To the Editor: We agree with the statement of Cohen and Cohen in their Sounding Board article on do-not-resuscitate (DNR) orders in the operating room (Dec. 26 issue)* that a policy of "required reconsideration" and a negotiated suspension of the DNR order is the best approach in the perioperative period. However, in their analysis the authors have omitted an important aspect of the issue that should be part of the discussion with the patient or surrogate — the assurance that if mechanical ventilation or the use of vasopressor agents is instituted during surgery, it can be discontinued postoperatively if the . . .