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Pediatr Blood Cancer. 2014 Feb;61(2):265-8. doi: 10.1002/pbc.24712. Epub 2013 Aug 12.

Association between religious and socio-economic background of parents of children with solid tumors and DNR orders.

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Department of Pediatric Oncology/Hematology, Meyer Children's Hospital, Rambam Health Care Campus, and Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.



The influence of socio-economic and religious background on decisions made by parents of children with incurable cancer regarding DNR orders is not fully understood.


A retrospective analysis of medical charts of patients who died between January 2000 and January 2011 was performed. The following data were sought: written evidence of DNR discussion with parents, religious background, educational level, monthly income.


There was evidence of a discussion on DNR in 73/90 charts. DNR consent was obtained in 14/17 (82.4%) cases where at least one parent had >15 years of education versus in only 24/45 (53.3%) cases where both parents had ≤15 years education as determined by univariate analysis (P = 0.03). DNR consent was also more likely to be obtained among parents of children with income >10,000 NIS (24/30, 80.0% vs. 20/38, 52.6%, P = 0.013). Parents of Jewish (22/30, 73.3%), Islamic (16/26, 61.5%), and Christian (8/9, 88.9%) background were equally likely to provide DNR consent. However, Druze families were less likely to do so (2/8, 25.0%, P = 0.036).


The process of decision-making to a DNR request was associated with parents' educational level and monthly family income, and not by religious background, with the exception of Druze families.


cancer; child; death; do not resuscitate; parent; religion; socio-economic status

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