To the Editor.
—The article by Ms O'Brien and colleagues1 raises some interesting questions about how much sense (not to mention cents) there is in offering certain treatment choices to patients. The outcomes reported suggest that more nursing home patients want CPR, artificial nutrition and hydration, and hospitalization than I would have expected. It is easy to see from the text included in the article that CPR was not described in a sufficiently negative light so as to dissuade the residents from choosing it. Providing a statistic of 5% survival does not fairly represent the likelihood of a successful outcome for an individual nursing home resident who may have multiple medical problems or whose cardiac arrest occurs outside the hospital, nor does it speak to the definition of successful resuscitation.2-4 It is also possible that alternatives to artificial nutrition and hydration and hospitalization were not sufficiently attractive to
Phipps E. Preferences for CPR and Life-Sustaining Treatment Among Nursing Home Residents. JAMA. 1996;275(17):1309. doi:10.1001/jama.1996.03530410023013