Abstract
Background: It has been reported that do-not-resuscitate (DNR) orders have been used inappropriately for people with learning disabilities (PwLD). The aim of this review is to use integrative methods to explore what is known about the use and utility of DNR orders for PwLD.
Methods: Integrative Review Updated Methodology by Whittemore and Knafl was used to guide the review. Five electronic databases were searched for articles between 2012-2023: CINAHL, PubMed, ProQuest, Google Scholar and all OVID databases, including of note PsychINFO, and a Google Advanced Search. Data were analysed and synthesised using constant comparison analysis.
Results: Six-hundred-and-seventy-eight (678) records were screened. Twenty-three were included in the analysis, comprising nine reports, seven research studies, five resources and two professional perspectives. The majority of the articles (n=17) articles originated from the United Kingdom. There is no consistency as to the use of DNR for PwLD, however four key themes were identified: Judgement, Assumptions and Perceptions of Disability; Capacity, Self-Determination, Rights and "Best Interests"; Consultation, Communication, and Information; and Practice and Process.
Conclusion: This review has identified a need for further research in this space to inform a clearer, more consistent approach to DNR use for PwLD that is in line with the UN Convention for the Rights of Peoples with Disabilities.