There is a growing emphasis on the quality of end-of-life communication. Already widely discussed is the widespread move from "DNR" to "DNAR" and "AND." But, today, at the ATS conference, I heard two examples of misunderstandings that caught me by surprise.
1. "Comfort care" - a resident thought that she had obtained family consent for "comfort care." In fact, the family thought that they were just consenting to keeping the patient "comfortable." Lesson: use "CMO." It more clearly indicates what exactly is involved.
2. "DNR" - a resident had placed DNR orders on all her patients. When asked what was going on, she replied that she thought "DNR" was for those patients for whom the discussion had not yet occurred.
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