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SMART 2003 - Milan, may 28-30
Weil M. H. 1,2
1 Institute of Critical Care Medicine, Palm Springs, CA
2 Keck School of Medicine, University of Southern California, Los Angeles, CA
Cardiopulmonary resuscitation (CPR) is the appropriate intervention to sustain respiratory and circulatory functions in patients with diseases that are potentially reversible; while CPR is unequivocally inappropriate for patients with terminal diseases when there is a consensus of medical opinion that is no reasonable likelihood of meaningful survival. In practical application patients and their families seek guidance based on understanding. CPR when employed without expectations of benefit, will be likely to further compromise neurological function, produce iatrogenic injury, and add discomfort to the dying patient. The decision not to resuscitate remains a reasoned medical judgement. In some condition, transferring the patient with terminal diseases to an alternate physician or institution is ultimately respectful both for the patient and of physician.