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February 13, 1995

Community Hospital Forbids the Use of Limited Code Orders

Author Affiliations

Delran, NJ

Arch Intern Med. 1995;155(3):330. doi:10.1001/archinte.1995.00430030128015

The Archives has recently published a series of articles1,2 on do-not-resuscitate orders, limited code status, and comfort care. One article1 was particularly interesting because it outlined ways to improve communication of code status between attending physicians and other staff members when the patient was on a limited code status.

My hospital's Critical Care Committee has decided that limited code status is always inappropriate and always unacceptable. At my hospital, a patient is considered for either a full code or a do-not-resuscitate order. The Critical Care Committee's argument is that you are either going to go all out to save a patient or you should do nothing at all.

I believe that there is a role for limited codes. For example, when a terminally ill patient will not agree to a do-not-resuscitate order (because the patient is afraid of abandonment or afraid to die), the patient will sometimes agree