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Reasons for Curtailing Cardiopulmonary Resuscitation

Bernadine Z. Paulshock, MD
Arch Intern Med. 1994;154(13):1539. doi:10.1001/archinte.1994.00420130137019.
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New do-not-resuscitate policies are certainly warranted; the attempt at cardiopulmonary resuscitation is futile in many of the dying patients in whom it is routinely used, cruel, unnecessary, and thus unwarranted, a presumptuous attempt to forestall imminent and inevitable death. Murphy and Finucane1 give us the statistics of the inefficacy and inappropriate performance of cardiopulmonary resuscitation at present. Why then should its cost be the reason for curtailing its performance? It should be curtailed because it is clinically inappropriate, and thus immoral. If it is used appropriately, a decline in its cost will be concomitant as it will be used so much less frequently than it is now when it has become a rite of passage except for the few who say no in advance.

Another recent article on the decision-making process with respect to useless therapies that may be incidentally expensive reminds us that "any intervention derives its justification


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