Prof. M Bacon
English. 170 sect. 13
Blackhall, Leslie J. ‘Must we always use CPR?’ New England Journal of medicine; November 12, 1987; 317(20): 1281-1285.
This article present a case in which the patient and the family made a decision in favor of resuscitation that ran contrary to the physician’s medical judgement. The author argues that, where a patient request for treatment in conflict with physician’s responsibility to provide what he or she believes to be good medical care, a resort to autonomy alone is insufficient. The principal of autonomy, which allow patient to refuse any procedure or choose among different beneficial treatment, does not allow them to demand nonbeneficial and potentially harmful procedure. This is important because CPR should not be considered an alternative to be offered by physicians in such cases. Instead, the physician should have listened to the patient’s hopes and fears, reassured him that the physician should would continue to be there and provide appropriate therapy, and, if necessary, refer the patient to psychiatric personnel or clergy.
Brunetti, Louis L,; Weiss, matthew J.; Studenski, Stephanie A.; Clipp, Elizabeth C. cardiopulmonary resuscitation policies and practices: a statewide nursing home study. Archives of internal medicine ; Jan. 1990; 150 (1): 121-126.
The author compare the content of written resuscitation policies of North Carolina nursing homes to ten model criteria regarded as important to the decisionmaking process: autonomy, informed consent, competency, dignity and quality of life, treatment alternatives, authorization, documentation, patient identification, review and medical condition. They found that nursing home policies were most likely to contain provisions that could be objectively measured and easily documented as required by law. This study is...
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