Doctors in Britain are expected to attempt resuscitation unless patients have agreed do not resuscitate orders. If patients are terminally ill, is discussion of such orders harmful or helpful?

Patients increasingly want to participate in decisions about their medical treatment. Although this is appropriate in most circumstances, discussing cardiopulmonary resuscitation with terminally ill patients is not practical, sensible, or in the patient's best interests. In these special situations, patient involvement is tokenism and entirely of negative value.

The UK guidelines on cardiopulmonary resuscitation require doctors to attempt resuscitation in all patients who have a cardiac or respiratory arrest unless a do not resuscitate order exists.1 Doctors are required to discuss the value of resuscitation with their patients before making a do not resuscitate order (box). However, discussion about cardiopulmonary resuscitation …