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QJM Advance Access originally published online on September 23, 2006
QJM 2006 99(10):711-715; doi:10.1093/qjmed/hcl097
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© The Author 2006. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Commentaries

Cardiopulmonary resuscitation: charting a course for the future

S. Workman

From the Department of Medicine, Division of General Internal Medicine, Dalhousie University, Halifax, Canada

Address correspondence to Dr S. Workman, Room 439 Bethune Building, QEII HSC, 1278 Tower Road Site, Halifax, Nova Scotia, Canada B3H 2Y9. email: stephen.workman@gmail.com

The first 150 words of the full text of this article appear below.


   Introduction
 
Imagine you have a choice. Tomorrow, you can either be dead, or you can choose a 1% chance of survival. For most of us, it's an easy decision; the odds of survival aren't good, but they are better than certain death. Now imagine that you are trying to persuade a patient not to receive cardiopulmonary resuscitation (CPR). ‘It almost certainly would not work, would only prolong the dying process,’ you explain. But CPR could work: there is perhaps a 1% chance of surviving to see another day. Why would patients choose not to receive it? However, despite most people's clear preference for continued life, the collective experience of clinicians is that CPR should not always be performed, and in many groups of patients, should only rarely be attempted. Individual physicians are required to respect this experience, while at the same time maintaining a high-quality doctor-patient relationship and providing realistic choices . . . [Full Text of this Article]


   The current climate
 

   The attraction of doing nothing
 

   CPR: efficacy and morbidity
 

   Opportunities for the future
 
Philosophical changes
Linguistic pitfalls
Structural changes and other improvements

   A course for the future: back to the past?
 

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