CPR in terminally ill patients?

While limiting and forgoing therapy at the end of life is now accepted on m edical, ethical, moral and legal grounds, many Americans continue to die wi th heroic measures being taken to prevent their death. When the patient doe s eventually die, attempts are frequently made to revive the patient by per forming cardiopulmonary resuscitation (CPR). While CPR may result in the es tablishment of a perfusing pressure, in almost all instances, the patient s uccumbs despite advanced life support technology. The widespread adoption o f do-not-resuscitate (DNR) protocols has not prevented CPR from being perfo rmed on patients, who are unlikely to survive. We present two cases, which highlight the modern American way of dying. We submit that poor end-of-life care may result from physicians discomfort with death, their poor communic ation skills and their failure to Fully comprehend the benefits and limitat ions of advanced life support technology. Furthermore, we maintain that CPR should only be performed on patients, who are likely to derive benefit fro m this intervention. (C) 2001 Elsevier Science Ireland Ltd. All rights rese rved.