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Family Consent to Orders Not to Resuscitate-Reply

Tom Tomlinson, PhD; Howard Brody, MD, PhD
JAMA. 1991;265(3):355-356. doi:10.1001/jama.1991.03460030060019.
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In Reply.—  We agree wholeheartedly with the reasons given by Dr Doukas for disclosure to the patient and family of the physician's decision against offering futile resuscitation, and we would add that we also agree fully with Dr Youngner's1 editorial warning against the conclusion that if consent isn't required, neither is communication. In the normal situation, there are plenty of good reasons for talking with patients or families about the wisdom of limiting treatment, even if protecting the patient's rights to choose treatment is no longer one of them. Dr Paradis is right to remind us that the involvement of multiple family members inevitably complicates discussion, which should take place despite the difficulties. If families are not offered the authority to make a decision about futile resuscitation, it may at least help avoid the attempted exercise of veto powers by individuals and the standoffs that result.Finally, we agree


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