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June 13, 1994

Universal Cardiopulmonary Resuscitation— A Flawed Standard of Practice

Author Affiliations

Huntington, WVa

Arch Intern Med. 1994;154(11):1291. doi:10.1001/archinte.1994.00420110139016

The recently published article1 and the accompanying editorial2 in the Archives would seem to advocate the position of universal cardiopulmonary resuscitation for all dying patients. The authors would suggest that the only way to know whether or not cardiopulmonary resuscitation may be effective is a trial of full resuscitation efforts. The American Heart Association has issued a statement that cardiopulmonary resuscitation is to be used in cases of unexpected and sudden cessation of vital signs. Use of cardiopulmonary resuscitation in patients with organ failure, metastatic cancer, and advanced acquired immunodeficiency syndrome may not be in the best interests of patients in the final stages of their lives.

Acceptance of an impending death has been a major failure of the American medical establishment over the last 30 years. Death has always been regarded as the dreaded enemy with an air of failure, guilt, and suspicion. Death may be better

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