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David P. Eisenman, MD
Bellevue Hospital Center New York, NY

JAMA. 1995;274(4):299-300.

	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.

—In the Editorial¹ regarding the study by Dr Curtis and colleagues,² Ms Alpers and Dr Lo note that the study may "underestimate problems" experienced at institutions without the "distinguished" bioethical experience of the setting of Curtis and colleagues. Specifically, I believe this to be true: in hospitals where physicians are not experienced with futility decisions, the "slow code" becomes the predominant method of limiting the inappropriate use of CPR.

A slow code is distinguished from other attempts at CPR by its purpose: to appear as a resuscitative effort but without the intention of therapeutic benefit for the patient. A slow code feigns medical therapy and serves nonmedical purposes such as avoiding the perceived legal risks of writing a DNAR order based on futility. During my residency training in internal medicine, completed in 1993 in New York City, the use of slow codes was common, while . . . [Full Text PDF of this Article]

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