Education And Debate For and against

Doctors should not discuss resuscitation with terminally ill patients

BMJ 2003; 327 doi: https://doi.org/10.1136/bmj.327.7415.614 (Published 11 September 2003) Cite this as: BMJ 2003;327:614

FOR

  1. Charlotte Manisty, senior house officer1,
  2. Jonathan Waxman, professor of oncology (j.waxman@ic.ac.uk)1
  1. Department of Cancer Medicine, Faculty of Medicine, Imperial College of Science, Technology and Medicine, Hammersmith Campus, London W12 0NN
  1. Correspondence to: J Waxman

    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 …

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