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June 26, 1995

Physicians as Patients: Choices Regarding Their Own Resuscitation

Author Affiliations

From the Departments of Internal Medicine (Dr Hillier) and Medical Education (Dr Hodges) and Internal Residency Program (Dr Rosenberg), Providence Medical Center, Portland, Ore; and Divisions of Pulmonary and Critical Care Medicine (Dr Patterson) and General Internal Medicine (Dr Hodges), Center for Ethics in Health Care (Dr Hodges), and Department of Medicine (Dr Rosenberg), Oregon Health Sciences University, Portland. Dr Hillier is now with the Division of Endocrinology and Metabolism, Department of Medicine, University of Virginia Health Sciences Center, Charlottesville.

Arch Intern Med. 1995;155(12):1289-1293. doi:10.1001/archinte.1995.00430120071009

Background:  Attitudes toward cardiopulmonary resuscitation have changed considerably during the last 30 years. Although physicians are routinely involved in the decision making about cardiopulmonary resuscitation for their patients, little is known about their collective preferences regarding it for themselves.

Methods:  A questionnaire was distributed at an internal medicine primary care review course at an urban community hospital. Of the 111 physicians registered at the meeting, 72 (65%) completed the questionnaire and serve as the basis for the results. Physicians were asked if they would want cardiopulmonary resuscitation for themselves in the presence of an acute myocardial infarction, Alzheimer's disease, and nine other advanced chronic diseases at the projected ages of 40, 60, and 80 years.

Results:  At all projected ages, physicians' desire for cardiopulmonary resuscitation with any advanced chronic disease was significantly less than with an acute myocardial infarction (P≤.000001 except for rheumatoid arthritis). Fewer physicians wanted cardiopulmonary resuscitation at age 80 years than at 40 years for any disease (P≤.002). The results did not differ when analyzed by respondents' age, gender, or primary care specialty, or the size of the community in which they practiced.

Conclusions:  The results of this initial survey indicate that most physicians would not want cardiopulmonary resuscitation with a variety of underlying chronic diseases and corresponding functional impairments— particularly with advancing age. Conversely, with an acute myocardial infarction, all physicians surveyed would desire cardiopulmonary resuscitation at age 40 years, and many would continue to desire it with advancing age.(Arch Intern Med. 1995;155:1289-1293)