LETTER
CPR-Not-Indicated and Futility
D. Malcolm Shaner, MD
1 January 1996 | Volume 124 Issue 1 Part 1 | Page 76
TO THE EDITOR:
Waisel and Truog [1] suggest that the medical decisions of physicians can be neatly separated from the value judgments that patients should make. By their reasoning, almost every patient whose surrogate claims that the patient would want CPR against the advice of their physician should receive it because the decision is partly a value judgment.
Let us admit that the decision to stop CPR is also value laden. It is not always medically clear when to stop resuscitation attempts. The heart and lungs of the permanently unconscious or terminally ill patient may be just one more chest compression away from recovery. Would Waisel and Truog suggest that we ask each patient or surrogate exactly how long they would like resuscitation attempts to be continued? If physicians cannot make value judgments regarding when to start CPR, certainly we should not be making value judgments regarding when to stop it.
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Author and Article Information
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Southern California Permanente Medical Group; Los Angeles, CA 90034
1. Waisel DB, Truog RD. The cardiopulmonary resuscitation-not-indicated order: futility revisited. Ann Intern Med. 1995; 122:304-8.
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