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Benefits vs the Harms of Automated External Defibrillator Use—Reply
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In Reply: Drs Landau, Jaffe, and Wentzel note that "accurate measures of memory, mental capacity, depression, personality, independent living skills, or even proof of complete recovery in the very best survivors" is needed and that "these data are essential to the ethical premise upon which public-access defibrillation is based". Considerable data are available regarding the neurologic outcomes in survivors of sudden cardiac arrest, as included in references 5 to 11 in our Commentary. In another study of 18 patients with witnessed cardiac arrest and ventricular fibrillation, AED use resulted in a rate of long-term survival with a good neurologic outcome of 10/18 (56%), which improved to 12/18 (67%) among patients in whom defibrillation was delivered within 5 minutes.1
In noting that the Federal Patient Self-Determination Act is directed toward inpatients, Landau et al advocate similar rights for persons who have a cardiac arrest outside of the hospital. The ethics of . . . [Full Text of this Article]
N. A. Mark Estes III, MD
nestes@tufts-nemc.org
Paul Weinberg, JD;
Hannah England, BA
New England Medical Center
Boston, Mass
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