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August 1979

Don't Just Do Something—Stand There!

Arch Intern Med. 1979;139(8):920-921. doi:10.1001/archinte.1979.03630450062020

The apparent transposition of the phrase that titles this article is not a mistake. It is intended to make the point that, at times, what appears at first to be a medical emergency is, in fact, nature's blessing that should be allowed to remove the suffering patient from hopeless and intolerable agony. Certainly our skills at respiratory and cardiac resuscitation should be deftly applied to individuals whose vital functions have suddenly failed by accident, disease, or trauma, to gain time for the resolution of acute reversible life-threatening processes affecting the circulatory and respiratory systems. By contrast, there are individuals for whom these resuscitation techniques only prolong the dying process and impose unnecessary suffering before the inevitable death occurs.

Faced with a patient with sudden cessation of respiratory and cardiac function, how does one decide whether intubation, mechanical ventilatory support, and reestablishment of cardiac function with closed chest massage and/or pharmacologic

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