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Health & Balance

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Questions & Answers: Advance Directives and End of Life Decisions

What is CPR (cardiopulmonary resuscitation)?

CPR is not a single treatment, but a group of treatments used when heartbeat and/or breathing stop. CPR tries to get the person to breathe and the heart to beat again. It may consist of chest compressions, mouth-to-mouth artificial respiration, forcing air into the lungs with a special device, electric shock or drugs to stimulate the heart, or fluids and medication given by vein.

Why would I not want CPR?

When a person is seriously ill and near death, it is not unusual for the heart to give out.

This kind of death can be more comfortable than slowly dying from a disease with death delayed by intrusive medical treatments. Research shows that very ill patients who have a cardiac arrest and are resuscitated in the hospital have only a very small chance of recovering enough to leave the hospital.

But in current medical practice, if the doctor has not written a DNR order for the patient, medical personnel usually try to resuscitate, no matter how hopeless the situation, and will keep trying until the heart simply will not restart.

In addition, if a person is resuscitated after not breathing even for just a few minutes, he or she may have severe brain damage because no oxygen has reached the brain. In that case, the resuscitation "succeeds" in the sense that the heart has restarted, but the patient is in a much worse condition than before the heart stopped.

When making the decision about your wishes regarding CPR, it is important to think about what condition you would be brought back to if your heart were to stop beating and CPR was initiated.

Do I need to talk with my agent about specific treatments in my living will?

Because it is impossible to predict exactly what will happen at the end of our lives, living wills and conversation cannot cover every situation. However, you should discuss the quality of life that matters to you, which offers your loved ones and physicians a guide to when you might want to refuse or accept medical treatment.

In addition, you should discuss your feelings about the use of life-sustaining treatments that are most commonly used in end-of-life situations and over which controversy might arise, such as ventilators (breathing machines), CPR, artificial nutrition and hydration, or antibiotics as well as continued medical testing.

If you have been diagnosed with a terminal illness, your physician can provide you with more specific information about future possibilities and treatments, enabling you to plan thoughtfully, prepare your documents clearly, and talk with your agent and other loved ones in an informed way.

WebMD Medical Reference from the National Hospice and Palliative Care Organization

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