To the Editor: There are challenging ethical, legal and clinical issues associated with resuscitation and end-of-life care for older people. When an elderly patient with comorbidities and limited independence deteriorates, and is unable to participate in decision making, is it good medical practice to subject that person to invasive and traumatic resuscitation when the survival rate is less than 3.4%?1
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- 1. O’Keeffe S, Redahan C, Keane P, Daly K. Age and other determinants of survival after in-hospital cardiopulmonary resuscitation. QJM 1991; 81: 1005-1010.
- 2. Australian Medical Council. Good medical practice: a code of conduct for doctors in Australia. http://www.amc.org.au/index.php/about/good-medical-practice (accessed Feb 2012).
- 3. Sidu NS, Dunkley ME, Egan MJ. “Not-for-resuscitation” orders in Australian hospitals: policies, standardised forms and patient information leaflets. Med J Aust 2007; 186: 72-75. <MJA full text>
- 4. McNeill D, Mohapatra B, Li J, et al. Quality of resuscitation orders in general medical patients. QJM 2012; 105: 63-68.
- 5. Shanmuganathan N, Li JYZ, Yong TY, et al. An audit of resuscitation orders and their relevance to patients’ clinical outcomes. QJM 2011; 104: 485-488.
- 6. Li JYZ, Yong TY, McNeill D, et al. The prevalence of resuscitation orders among residents from aged care facilities admitted to general medical units. Geriatr Gerontol Int 2012; 12: 364.
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