Must We Always Use CPR?
Blackhall, Leslie J.
New England Journal of Medicine. 1987 Nov 12; 317(20): 1281-1285.
Referring to studies assessing the outcomes of cardiopulmonary resuscitation (CPR), a physician discusses the inappropriate application of CPR with critically or terminally ill patients, using a woman in relapse with acute myelogenous leukemia as an example. The patient and her family consented in advance to CPR, not understanding that resuscitation most likely would prolong her life only a short time and would result in her dying in the intensive care unit. Blackhall argues that CPR should not be offered when it will not benefit a patient and that, when the prognosis is uncertain, the harms and benefits of CPR should be discussed with the patient in time for an informed decision about its use to be made. A "physician's duty to provide responsible medical care," Blackhall concludes, "precludes CPR, either as a routine process...or as a response to a patient's misguided request...in the absence of adequate information." (KIE abstract)
Autonomy; Critically Ill; Consent; Decision Making; Diagnosis; Disclosure; Evaluation; Family Members; Hospitals; Informed Consent; Leukemia; Life; Moral Policy; Mortality; Patient Participation; Patients; Physicians; Prognosis; Prolongation of Life; Quality of Life; Resuscitation; Resuscitation Orders; Risks and Benefits; Selection for Treatment; Statistics; Terminally Ill; Third Party Consent; Treatment Refusal;