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ETHICS IN MEDICINE   University of Washington School of Medicine

Do Not Resuscitate Orders:
Case 2 Discussion

Mrs. W is elderly and has a diagnosis of metastatic cancer. In several prospective outcome studies of CPR in the hospital, patients like Mrs. W had 0% survival. Thus CPR for Mrs. W could be called "futile."

Many hospital policies permit withholding CPR based on medical futility however; other strategies to improve communication should be employed first. You should allow Mrs. W some time to come to grips with her diagnosis, while periodically re-addressing the CPR question with her. This is best done in the context of other medical decision that occur during her care. It is important to review other care goals with her, to allay possible fear that a DNR order may mean she will be abandoned or not cared for.

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