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Deciding Whether to Resuscitate
Bernard Lo, MD;
Robert L. Steinbrook, MD
Arch Intern Med. 1983;143(8):1561-1563.
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| Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings. |
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Cardiopulmonary resuscitation (CPR) may be inappropriate for patients with multiple chronic illnesses for whom cardiopulmonary arrest is the inevitable result of a worsening clinical course. Cardiopulmonary resuscitation usually is unsuccessful in such patients; moreover, many patients with chronic or terminal illness do not want the natural course of dying interrupted by CPR.
Do not resuscitate (DNR) orders are orders not to initiate CPR. The principles justifying and the procedures for making DNR orders have been discussed. Guidelines recommend that a DNR order may be written if further medical treatment is futile and/or if the competent patient does not want CPR.1-5
Applying general guidelines, however, may be difficult, as the following cases illustrate.
REPORT OF CASES
CASE 1.
—A 30-year-old woman had had Gardner's syndrome and carcinoma of the colon with lung, skin, bone, and epidural metastases. Despite a laminectomy and radiation therapy, she was paraplegic.
She was admitted to
. . . [Full Text PDF of this Article]
Author Affiliations
From the Division of General Internal Medicine (Drs Lo and Steinbrook) and the Institute for Health Policy Studies (Dr Lo), University of California, San Francisco.
Footnotes
Accepted for publication April 18, 1983.
Reprint requests to the Division of General Internal Medicine, 400 Parnassus Ave, Room A-405, University of California, San Francisco, CA 94143 (Dr Lo).
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