[Let us not resuscitate the dead]

Cardiopulmonary resuscitation (CPR) was developed as a preventive measure for sudden and unexpected death. This excellent technique has been misguided. It has been turned into an unmerited and cruel ritual in the horizon of all who are to die. CPR is particularly ineffective in the elderly. Of 503 patients age 69 or over subjected to CPR in 5 medical centers in Boston only 19 (3.8%) were alive at discharge. In 68.8% or them death occurred in less than 3 days. Only 2 of 244 patients who arrived at the hospital with a cardiorespiratory arrest survived; the 209 who arrived without vital signs died. One of 37 patients with an oxygen tension less than 63 torr left the hospital alive but connected to a respirator. All patients (204) with one or more of the following laboratory findings died: Hematocrit less than 35%, creatinine more than 1.5 mg/dl or a BUN more than 65 mg/ml, serum albumin less than 2.7 gr/dl. The rights of patients over their life and their history are violated when CPR is applied without their consent. In a recent study 63% of 104 hospitalized patients and 73% of 922 Puerto Rican doctors and nurses preferred not be subjected to CPR unless there was an opportunity for a complete functional recovery. Six percent would not have CPR under any circumstance. Health professionals should not continue avoiding their moral responsibilities shielded by institutional policies or hiding behind a simplistic religiosity. It is immoral to prolong the agony of dying patients. Let us cease the useless resuscitation of the dead.