To the Editor.—
I commend Faber-Langendoen on her excellent article1 reviewing the use and misuse of cardiopulmonary resuscitation for patients with metastatic cancer. As a senior internal medicine resident at an academic community hospital, I am frequently confronted by the situation that the author alludes to in the article—being called to resuscitate a dying patient with cancer who lacks a do not resuscitate (DNR) order despite the likely futility of resuscitative efforts. In my own experience, attempting resuscitation in such a setting is both degrading to the human dignity of the patient and frustrating to the house staff who find themselves unintentionally crushing frail sternum and ribs. Dying patients ought to be protected from such desecration of their bodies at the moment of demise. Unfortunately, DNR orders are too often lacking when they are needed the most.I have seen an oncologist become irate at house staff who suggested
Green M. Cardiopulmonary Resuscitation and the Dying Patient With Cancer: A Resuscitator's Response. Arch Intern Med. 1992;152(7):1529–1530. doi:10.1001/archinte.1992.00400190145030
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