Re "Outcry follows woman's refusal to do CPR" (Capitol & California, March 5): As a geriatrician, I see a different tragedy with the 87 year old Bakersfield woman who did not have CPR. I see a culture refusing to embrace death as an event as natural as being born.
For an 87 year old, the CPR survival rate is almost zero. The risk for severe internal injuries from crushing brittle ribs is high. Even in the "best" outcomes, survival is accompanied by severe functional and cognitive deficits and a life expectancy of less than two weeks.
Something like 80 percent of heath care dollars are spent in the last two years of someone's life. Subjecting patients to futile aggressive treatments and procedures is often the result of a physician's fear of failure. Better end-of-life education for physicians and patients alike can help improve the survival of our health care system and the quality of life of our elderly.
-- William Nesbitt, M.D., Sacramento
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