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Nancy S. Jecker, PhD
Seattle, Wash

Lawrence J. Schneiderman, MD
La Jolla, Calif

Arch Intern Med. 1993;153(10):1268.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

We appreciate Ayers' comments calling attention to an earlier (1964) and overlooked article¹ that he wrote with his colleague, Joseph Doyle. The article reviews the outcomes of 48 patients who received cardiopulmonary resuscitation on the wards and in the emergency department of a 700-bed general hospital.

Although this early study concerned in-hospital resuscitation, and the primary concern of our article² was with out-of-hospital resuscitation, the study by Ayers and Doyles, nonetheless, provides additional confirmation for the general thesis that our article supports; namely, certain categories of patients who are receiving cardiopulmonary resuscitation are inappropriate candidates for it. We reiterate that cardiopulmonary resuscitation is not the ordinary ethical obligation of health professionals when it has a very low likelihood of success (quantitative futility) or is associated with a very poor quality of outcome (qualitative futility).² . . . [Full Text PDF of this Article]

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