February 13, 1995

Community Hospital Forbids the Use of Limited Code Orders-Reply

Author Affiliations

Oakland, Calif

San Francisco, Calif

Arch Intern Med. 1995;155(3):330. doi:10.1001/archinte.1995.00430030128016

In reply  The decision to limit potentially life-sustaining treatment should be a shared decision between the patient or surrogate and the physician. It should be based on the burdens and benefits of each procedure evaluated in terms of the patient's values and goals.1Thus, the rationale that "you are either going to go all out to save a patient or you should do nothing at all" is seriously flawed. For example, patients who decline chemotherapy may still receive antibiotics for infection and transfusion for anemia.Partial code status is correctly criticized if it is deceptive or irrational. Occasionally it serves to respect patient values such as the case of the patient with severe chronic lung disease and cardiac disease, who is desperately afraid of intubation, but who will accept a brief resuscitation and cardioversion.We believe that do-not-resuscitate orders have many rationales and may convey unintended meanings. Thus, we

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