Profound Developmental Delay in Patient Safety, Preventive & Ethics — Case | Ethics | SMLE Q#12408

A 3-month-old boy has severe hypoxic-ischemic encephalopathy after perinatal asphyxia with profound developmental delay and total dependence. He has an unsafe swallow and recurrent aspiration pneumonias while being fed via a nasogastric tube. His parents signed a do-not-resuscitate (DNR) order specifying no chest compressions or intubation if cardiopulmonary arrest occurs, but they request ongoing comfort measures and enteral feeding. Pediatric surgery plans elective gastrostomy tube placement. The anesthesiologist asks how to manage the existing DNR for this procedure. What is the most appropriate course of action?