Do not resuscitate or Allow natural death, does it make a difference?

Do words matter, or is it just semantics?

A recent article in the USA Today highlights a study showing that nurses, student nurses and people with no health care backgrounds all “reported a greater likeliness to forgo resuscitation if ‘allow natural death’ was used.”

Palliative care physician Christian Sinclair sheds more light on the topic, noting the ambiguity of “Allow natural death.”

“What did it mean exactly as a medical order?” writes Dr. Sinclair. “Is morphine natural? Are antibiotics natural? Does this patient consider artificial hydration or nutrition as natural (To some that is a contradiction but others would disagree)? It left too many questions for me to consider it a helpful or accurate medical order.”

It appears, anecdotally, that families see “Allow natural death” to be more compassionate wording in end-of-life situations. But, is that compassion from the order itself, or “in the communication of the medical plan once the goals have been delineated?”

In other words, it may not be so much what you order, but how you say it.