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June 14, 1993

Failure of 'Predictors' of Cardiopulmonary Resuscitation Outcomes to Predict Cardiopulmonary Resuscitation Outcomes: Implications for Do-Not-Resuscitate Policy and Advance Directives

Author Affiliations

Veterans Affairs Medical Center 1400 Veterans of Foreign Wars Pkwy West Roxbury, MA 02132

Arch Intern Med. 1993;153(11):1293-1296. doi:10.1001/archinte.1993.00410110009002

CARDIOPULMONARY RESUSCITATION (CPR) has saved countless lives over the decades since it was described and became established as a lifesaving technique. Through this period, there have been phases in which the withholding of CPR for any reason was thought to be a basis for a malpractice claim. More recently, the focus has been on the overuse of CPR in cases in which its use was futile or the recipient would have declined the pleasure had he been queried. The fact that failure could result in death was an acceptable risk, but the possibility that the resuscitative effort could result in a permanent vegetative state was daunting, indeed. Vigorous efforts have been undertaken to develop criteria by which the patient for whom CPR would be futile or result in an undesirable outcome could be identified in advance. These efforts were energized early by the horror of a patient in a permanently