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Stuart J. Youngner, MD

JAMA. 1988;260(14):2094-2095.

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

FOR THE past two decades, our society has struggled to identify the proper circumstances under which life-sustaining medical treatment should be limited. In fact, we seem to have reached a consensus on some aspects of the problem. It is generally agreed that a competent patient has the right to refuse life-sustaining treatment; when the patient is not competent, family members may limit treatment to serve the patient's best interests.

The report by Murphy¹ in this issue of THE JOURNAL examines a more controversial question that is currently at the forefront of the treatment-limitation debate—ie, under what circumstances can life-sustaining interventions be limited without the informed consent of the patient or family?

Murphy notes correctly that cardiopulmonary resuscitation (CPR) is "rarely effective and in many cases futile" in the setting of a long-term—care facility, where many elderly patients are chronically ill or severely demented. He proposes a policy that "enables . . . [Full Text PDF of this Article]

Author Affiliations
From the Departments of Psychiatry and Medicine and the Center for Biomedical Ethics, Case Western Reserve University School of Medicine, University Hospitals of Cleveland.

Footnotes
Reprint requests to University Hospitals, 2074 Abington Rd, Cleveland, OH 44106 (Dr Younger).

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