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Lee S. Glass, MD, JD
Mercer Island, Wash

JAMA. 1986;256(8):999-1000.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

Charlson et al¹al1 provide an elegant study of treatment decisions in the hospitalized, potentially terminally ill patient. Despite the clarity of the insight they provide and the data they have so carefully presented, I must take exception with at least some of their conclusions. They have suggested that issues of intervention and resuscitation be discussed not with all severely ill or moribund patients but "with patients whose hospital course is characterized by a slow, progressive deterioration." That assertion represents a philosophical viewpoint, not one that necessarily follows at all from the data provided.

The authors state that conducting "discussions about resuscitation with all of the patients would provoke unnecessary anxiety," a result the authors reasonably seek to avoid. Targeting the identified group, the authors further assert, would meet medicolegal concerns. Most (70%) of the studied patients who died would have participated in such discussions, and . . . [Full Text PDF of this Article]

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