RT Journal
A1 Blinderman CD, Krakauer EL, Solomon MZ
T1 TIme to revise the approach to determining cardiopulmonary resuscitation status
JF JAMA
JO JAMA
YR 2012
FD March 7
VO 307
IS 9
SP 917
OP 918
DO 10.1001/jama.2012.236
UL http://dx.doi.org/10.1001/jama.2012.236
AB 
Whenever there is a plausible risk of cardiac arrest, the standard approach is to ask patients or their surrogates about their preferences regarding CPR. However, the very act of asking can suggest to the patient and family that CPR may be beneficial, even when the clinician believes otherwise. Additionally, research in cognitive psychology has revealed that default options are often interpreted as recommendations or guidelines, or as the path of least resistance, and that such default options significantly affect decision making.1 For these reasons, patients or their surrogates may be biased toward choosing full resuscitation status, even when CPR likely would bring little or no benefit and would risk considerable harm. Therefore, the standard approach of neutrally seeking consent to withhold CPR may inadvertently diminish patients' and families' comprehension of the clinical situation and lead to decisions that are grounded neither in patients' values2 nor in their best interest.