WHEN CAN ELDERLY PATIENTS BE EXCLUDED FROM DISCUSSING RESUSCITATION

Case notes of elderly medical patients were surveyed to determine when 'do not resuscitate' (DNR) decisions could legitimately be made witho ut consulting them. Patients were thought to be suitable for exclusion from decisions if morbidity scores indicated that they were unlikely to survive cardiopulmonary resuscitation (CPR) or if they were mentall y incompetent. Thirty per cent of all patients were predicted not to s urvive CPR; another 28% were deemed incompetent. Of those with DNR dec isions, 59% were predicted not to survive and a further 24% were incom petent. Discussing resuscitation would have been appropriate with 17% of those with DNR decisions.