Physicians as patients. Choices regarding their own resuscitation.

BACKGROUND

Attitudes toward cardiopulmonary resuscitation have changed considerably during the last 30 years. Although physicians are routinely involved in the decision making about cardiopulmonary resuscitation for their patients, little is known about their collective preferences regarding it for themselves.

METHODS

A questionnaire was distributed at an internal medicine primary care review course at an urban community hospital. Of the 111 physicians registered at the meeting, 72 (65%) completed the questionnaire and serve as the basis for the results. Physicians were asked if they would want cardiopulmonary resuscitation for themselves in the presence of an acute myocardial infarction, Alzheimer's disease, and nine other advanced chronic diseases at the projected ages of 40, 60, and 80 years.

RESULTS

At all projected ages, physicians' desire for cardiopulmonary resuscitation with any advanced chronic disease was significantly less than with an acute myocardial infarction (P < or = .000001 except for rheumatoid arthritis). Fewer physicians wanted cardiopulmonary resuscitation at age 80 years than at 40 years for any disease (P < or = .002). The results did not differ when analyzed by respondents' age, gender, or primary care specialty, or the size of the community in which they practiced.

CONCLUSIONS

The results of this initial survey indicate that most physicians would not want cardiopulmonary resuscitation with a variety of underlying chronic diseases and corresponding functional impairments--particularly with advancing age. Conversely, with an acute myocardial infarction, all physicians surveyed would desire cardiopulmonary resuscitation at age 40 years, and many would continue to desire it with advancing age.