Resuscitation – Who wins life’s lottery

One hundred oncology patients from a major teaching hospital were studied regarding their attitudes and those of their treating doctors to a number of final life events: treatment withdrawal, declining life support measures, suicide and euthanasia. A descriptive approach including semi-structured interviews of patients and medical staff and established questionnaire measures was used.

This paper examines the resuscitation aspects of the study. One third of the patient sample anticipated a time when they would not consent to cardiopulmonary resuscitation (CPR). This was significantly associated with good prognosis disease and a positive psychiatric history. Staff reported that they planned to provide half the sample intensive CPR, (including Intensive Care support) while 32% were designated for ward-based CPR only. 18% would "Not Be Resuscitated". They were older, had more treatment side effects and a poorer quality of life, and were more likely to have either a psychiatric past history or higher depressive affect. These results are significant for the development of CPR protocols.

Associated Publication(s):
Owen C, Tennant C, Levi J, Jones M. Resuscitation. Patient and staff attitudes in the context of cancer. General Hospital Psychiatry 1992 Sep; 14(5):327-33