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[Let us not resuscitate the dead].

J Ramírez Rivera1

  • 1Programa de Cuidado Ambulatorio, Hospital de Veteranos, San Juan, Puerto Rico 00927-5800.

Boletin De La Asociacion Medica De Puerto Rico
|November 1, 1991
PubMed
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Cardiopulmonary resuscitation (CPR) is often ineffective, especially in the elderly, leading to prolonged suffering. Patients and healthcare professionals increasingly prefer to forgo CPR unless full recovery is likely, questioning its ethical application.

Area of Science:

  • Geriatric Medicine
  • Emergency Medicine
  • Bioethics

Context:

  • Cardiopulmonary resuscitation (CPR) is a medical intervention for sudden cardiac arrest.
  • Its application in elderly and critically ill patients is debated due to low survival rates.
  • Patient autonomy and quality of life are increasingly considered in end-of-life care decisions.

Purpose:

  • To evaluate the effectiveness of CPR in elderly patients.
  • To analyze patient and healthcare professional preferences regarding CPR.
  • To discuss the ethical implications of CPR in end-of-life care.

Summary:

  • CPR demonstrated a low survival rate (3.8%) in patients aged 69+.
  • Survival was particularly poor for patients arriving with cardiorespiratory arrest or specific laboratory abnormalities.

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  • A significant majority of patients and healthcare professionals preferred not to undergo CPR without a chance for functional recovery.

    • Impact:

    • Challenges the routine use of CPR in elderly and terminally ill patients.
    • Highlights the importance of patient consent and preferences in medical decision-making.
    • Calls for a re-evaluation of CPR's role in end-of-life care to prevent unnecessary suffering.