Cardiopulmonary resuscitation (CPR). Patient factors and decision making

Abstract

Because of the 1978 decision by a New Jersey courtIn the Matter of Shirley Dinnerstein,1the determination of [ill]de status" has been placed squarely in the hands of the [ill]hysician. Medical technology has allowed for maximal [ill]esaving efforts of considerable expense when patients [ill]ave cardiac arrest. It is recognized that in some patients [ill]ith severe chronic, progressive, or end-stage disease that [ill] irreversible, cardiopulmonary resuscitation (CPR) [ill]ould be withheld.2 Although most physicians would agree that patients or [ill]eir families should be involved in the decision of whether [ill]o not resuscitate" orders should be written, the real [ill]tential for their contribution is questionable. The report [ill]om the President's Commission for the Study of the [ill]thical Problems in Medicine and Biomedical and Behav[ill]al Research3advocates the need for decision making by [ill]tients or their surrogates regarding foregoing life-sus[ill]ining and resuscitation measures. It also indicates, how[ill]er, that even though patient self-determination should