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Article   |    
Do-Not-Resuscitate Orders for Depressed Psychiatric Inpatients
Linda Ganzini; Melinda A. Lee; Ronald T. Heintz; Joseph D. Bloom
Psychiatric Services 1992; doi:
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This work was partly supported by the Medical Research Foundation of Oregon. The authors thank Jackie Lockwood for assistance in manuscript preparation.

Veterans Affairs Medical Center (116A-P), P.O. Box 1034, Portland, Oregon 97207; Oregon Health Sciences University

Dammasch (Ore.) State Hospital

1992 by the American Psychiatric Association

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Abstract

Many patients, especially those who are elderly and who have chronic medical illnesses, choose to forgo cardiopulmonary resuscitation (CPR) in case of cardiac arrest. The right of mentally competent patients to refuse CPR is supported by ethicists, the courts, and medical associations. Psychiatrists are increasingly presented with dilmmas about resuscitation preferences of elderly psychiatric inpatients whose decision-making capacity may be impaired because of mental illness such as depression. The authors discuss justifications for patients' refusing resuscitation, the role of advance directives in communicating patients' preferences, and the use of do-not-resuscitate orders for depressed psychiatric inpatients. Survival rates after CPR among elderly patients with chronic medical illnesses are low. Patients and their families need accurate information about the risks and benefits of CPR and about the consequences of refusing the procedure.

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Do-not-resuscitate orders for depressed psychiatric inpatients. Hosp Community Psychiatry 1992;43(9):915-9.
Depression and mortality in medically ill older adults. J Am Geriatr Soc 1997;45(3):307-12.