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Article
July 26, 1993

New Do-Not-Resuscitate Policies: A First Step in Cost Control

Author Affiliations

Denver, Colo; Baltimore, Md

Arch Intern Med. 1993;153(14):1641-1648. doi:10.1001/archinte.1993.00410140023003
Abstract

TO CONTROL the cost of health care and to improve access to care for the uninsured, our society will have to set limits on health care use. We believe that new do-not-resuscitate (DNR) policies would be just and relatively painless ways of beginning to set these limits. New policies could be developed with public input at the hospital, city, or county levels. We suggest a DNR policy that eliminates cardiopulmonary resuscitation (CPR) for certain groups of people who are near death and that CPR no longer be considered part of standard care for these patients. The major rationale for this policy change is cost control. Our society cannot achieve real cost control until we agree to set limits. This new policy would have many additional advantages. It would help to (1) protect many patients who are near death from over-treatment, (2) operationalize the concept of futility, (3) reflect the majority's

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