My associates and I noted with special interest the contribution of Karetzky et al1 in the June 26, 1995, issue of the Archives on cardioplumonary resuscitation (CPR) in intensive and non— intensive care units. We were especially interested in the strikingly low 1-year survival rate of only 2.5% in patients who had received CPR in intensive care units. This rate contrasted with the significantly better outcomes in patients who were hospitalized outside of the intensive care unit. Karetzky and colleagues point to the futility of routine CPR as presently practiced and as documented by these data. They conclude that such disappointing outcomes of current CPR interventions may not be appreciated by either physicians or patients to the extent that they are persuaded to forgo CPR when there is very remote likelihood of success.
However, the literature, including the article by Karetzky and colleagues, provides an even greater challenge. In