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R. Ayres (1990)
Current Controversies in Prehospital Resuscitation of the Terminally Ill PatientPrehospital and Disaster Medicine, 6
L. Schneiderman, R. Pearlman, Robert Kaplan, John Anderson, Esther Rosenberg (1992)
Relationship of general advance directive instructions to specific life-sustaining treatment preferences in patients with serious illness.Archives of internal medicine, 152 10
T. Tomlinson, H. Brody (1990)
Futility and the ethics of resuscitation.JAMA, 264 10
L. Schneiderman, R. Spragg (1988)
Ethical decisions in discontinuing mechanical ventilation.The New England journal of medicine, 318 15
National Association of Emergency Medicine (1986)
Ethics in Emergency Medicine
M. Bonnin, R. Swor (1989)
Outcomes in unsuccessful field resuscitation attempts.Annals of emergency medicine, 18 5
M. Angell (1991)
The case of Helga Wanglie. A new kind of "right to die" case.The New England journal of medicine, 325 7
Barker WH Mott PD (1988)
Hospital and medical care use by nursing home patientsJ Am Geriatr Soc., 36
D. Murphy, A. Murray, B. Robinson, E. Campion (1989)
Outcomes of Cardiopulmonary Resuscitation in the ElderlySurvey of Anesthesiology, 34
Iserson KV (1991)
Foregoing prehospital careJ Med Ethics., 17
Marshall L (1985)
Resuscitating the terminally illJ Emerg Med Serv., 11
Veatch RM (1990)
Prescriptions: The Dissemination of Medical Authority
Iserson KV (1989)
Prehospital DNR orders: commentaryHastings Cent Rep., 19
Appleton W (1988)
Emergency Medicine: A Comprehensive Study Guide
L. Marshall (1985)
Resuscitating the terminally ill.JEMS : a journal of emergency medical services, 10 4
Geddes JS Pantridge JF (1967)
A mobile intensivecare unit in the management of myocardial infarctionLancet., 2
Ellen Fox, Mark Siegler (1992)
Redefining the emergency physician's role in do-not-resuscitate decision-making.The American journal of medicine, 92 2
American College of Emergency Physicians (1985)
Medical, moral, legal and ethical aspects of resuscitation for the patient who will have minimal ability to function or ultimately surviveAnn Emerg Med., 14
(1982)
CPR: When the Beat Should Stop
P. Podrid (1989)
Resuscitation in the elderly: a blessing or a curse?Annals of internal medicine, 111 3
Emergency Medical Control and Protocols Committee (1986)
Control of prehospital care at the scene of emergenciesMinn Med., 69
American Medical Association (1986)
Standards and guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiac care (ECC), VIIIJAMA., 255
P. Auerbach, J. Morris, J. Phillips, S. Redlinger, W. Vaughn (1987)
An analysis of ambulance accidents in Tennessee.JAMA, 258 11
Miles SH Lantos JD (1988)
Survival after cardiopulmonary resuscitation in babies of very low birth weight: is CPR futile therapy?N Engl J Med., 318
N. Jecker, R. Pearlman (1992)
Medical futility. Who decides?Archives of internal medicine, 152 6
L. Blackhall (1987)
Must we always use CPR?The New England journal of medicine, 317 20
Crimmins Tj (1988)
Ethics, law, and emergency medicine.Minnesota medicine, 71
J. Hackler, F. Hiller (1990)
Family consent to orders not resuscitate. Reconsidering hospital policy.JAMA, 264 10
Americancollegeofemergencyphy (1985)
Medical, moral, legal, and ethical aspects of resuscitation for the patient who will have minimal ability to function or ultimately survive. American College of Emergency Physicians, Dallas, Texas.Annals of emergency medicine, 14 9
S. Miles, T. Crimmins (1985)
Orders to limit emergency treatment for an ambulance service in a large metropolitan area.JAMA, 254 4
Meisel A (1979)
The 'exceptions' to the informed consent doctrineWis Law Rev.
R. Faden, N. King, T. Beauchamp (1986)
A History and Theory of Informed ConsentAmerican Political Science Review, 82
Murray AM Murphy DJ (1989)
Outcomes of cardiopulmonary resuscitation in the elderlyAnn Intern Med., 111
S. Miles (1987)
Advanced Directives to Limit Treatment: The Need for PortabilityJournal of the American Geriatrics Society, 35
R. Veatch (1989)
Contemporary Bioethics and the Demise of Modern MedicineBioethics News, 8
Schneiderman LJ Jecker NS (1992)
Rationing and futilityAm J Med., 92
A. Kellermann, Diane Staves, B. Hackman (1988)
In-hospital resuscitation following unsuccessful prehospital advanced cardiac life support: 'heroic efforts' or an exercise in futility?Annals of emergency medicine, 17 6
Capone RJ Gray WA (1991)
Unsuccessful emergency medical resuscitationN Engl J Med., 325
Raffin TA Ruark JE (1988)
The Stanford University Medical Center committee on ethicsN Engl J Med., 318
Hastings Center (1987)
Guidelines for the Termination of Life-Sustaining Treatment
Greg Sachs, S. Miles, Rebekah Levin (1991)
Limiting resuscitation: emerging policy in the emergency medical system.Annals of internal medicine, 114 2
J. Ruark, T. Raffin (1988)
Initiating and Withdrawing Life SupportThe New England Journal of Medicine, 318
J. Pantridge, J. Geddes (1966)
Cardiac arrest after myocardial infarction.Lancet, 1 7441
L. Schneiderman, N. Jecker, A. Jonsen (1990)
Medical futility: its meaning and ethical implications.Annals of internal medicine, 112 12
K. Iserson, F. Rouse (1989)
Case Studies: Prehospital DNR OrdersHastings Center Report, 19
S. Steiber (1987)
Right to die: Public balks at deciding for othersDimensions of Critical Care Nursing, 6
B. Haynes, J. Niemann (1985)
Letting go: DNR orders in prehospital care.JAMA, 254 4
S. Bedell, T. Delbanco, E. Cook, F. Epstein (1983)
Survival after Cardiopulmonary Resuscitation in the HospitalThe New England Journal of Medicine, 309
Miles SH Sachs GA (1991)
Limiting resuscitationAnn Intern Med., 114
W. Gray, R. Capone, A. Most (1991)
Unsuccessful emergency medical resuscitation--are continued efforts in the emergency department justified?The New England journal of medicine, 325 20
R. Hoffman (1988)
Resuscitation in the elderly.Chest, 94 5
N. Jecker (1991)
Knowing when to stop: the limits of medicine.The Hastings Center report, 21 3
Americancollegeofemergencyphy (1988)
Guidelines for 'do not resuscitate' orders in the prehospital setting. American College of Emergency Physicians.Annals of emergency medicine, 17 10
Wrenn Keith, S. Brody (1992)
Do-not-resuscitate orders in the emergency department.The American journal of medicine, 92 2
S. Miles (1991)
Informed demand for "non-beneficial" medical treatment.The New England journal of medicine, 325 7
W. Weaver (1991)
Resuscitation outside the hospital--what's lacking?The New England journal of medicine, 325 20
Duralde T Eliastam M (1977)
Cardiac arrest in the emergency medical service system: guidelines for resusciationJ Am Coll Emerg Phys., 6
J. Lantos, S. Miles, M. Silverstein, C. Stocking (1988)
Survival after cardiopulmonary resuscitation in babies of very low birth weightDimensions of Critical Care Nursing, 8
Staves DR Kellerman AL (1988)
In-hospital resuscitation following unsuccessful prehospital advanced cardiac life supportAnn Emerg Med., 17
American College of Emergency Physicians (1988)
Guidelines for 'do not resuscitate' orders in the prehospital settingAnn Emerg Med., 17
(1966)
Cardiopulmonary resuscitationJAMA., 198
Steiber SR (1987)
Right to die: public balks at deciding for othersHospitals., 61
K. Faber‐Langendoen (1991)
Resuscitation of patients with metastatic cancer. Is transient benefit still futile?Archives of internal medicine, 151 2
D. Doukas (1991)
Family Consent to Orders Not to ResuscitateJAMA, 265
P. Mott, W. Barker (1988)
Hospital and Medical Care Use by Nursing Home Patients: The Effect of Patient Care PlansJournal of the American Geriatrics Society, 36
Podrid PJ (1989)
Resuscitation in the elderlyAnn Intern Med., 111
G. Taffet, Thomas Teasdale, Robert Luchi (1988)
In-hospital cardiopulmonary resuscitation.JAMA, 260 14
N. Jecker, L. Schneiderman (1992)
Futility and rationing.The American journal of medicine, 92 2
T. Crimmins (1990)
The Need for a Prehospital DNR SystemPrehospital and Disaster Medicine, 5
S. Miles, C. Gómez (1989)
Protocols for Elective Use of Life-Sustaining Treatments
K. Iserson (1991)
Foregoing prehospital care: should ambulance staff always resuscitate?Journal of Medical Ethics, 17
R. Besdine (1983)
Decisions to Withhold Treatment from Nursing Home ResidentsJournal of the American Geriatrics Society, 31
Maggiore WA (1991)
Withholding resuscitationJ Emerg Med Services., 16
Abstract This article explores ethical decision making in the prehospital emergency setting with particular attention to emergency cardiac care. The first sections argue in support of current efforts to develop portable do-not-resuscitate (DNR) policies enabling patients' wishes to be honored outside the hospital setting. We then turn to the topic of futile resuscitation, and elaborate and defend a proposal to allow emergency personnel to cease futile resuscitation in the field. We submit that unlike the decision to write a DNR order, the judgment that resuscitation is futile ought not to depend on a patient's prior wishes. Instead, it should reflect a professional consensus and receive support from reliable empirical data. Finally, we acknowledge the difficulty of rendering reliable determinations of futility in the field, and show through case examples and empirical studies how effective policies can be implemented. 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Archives of Internal Medicine – American Medical Association
Published: Dec 1, 1992
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