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End Of Life Rituals:the Beneficence Of Futile Cardiopulmonary Resuscitation
Gregory L. LARKIN, MD,a
aMS, MSPH, Professor of Surgery, Emergency Medicine, and Public Health Director of Academic Development Department of Surgery, University of Texas Southwestern Medical Center at Dallas
Since the Enlightenment, medical culture has been progressively transformed by new science, a medical industrial revolution, and the emergence of a modern medical technocracy in many parts of the world. As physicians don the miter of this technocracy, they may trivialize the cultural, medical, and religious rituals that were once the mainstay of the healer's art. In the wake of discarded ritual, a monotonic focus on science has stifled healing and nearly eclipsed humanistic and religious acts of caring. Since the Art of medicine has become the Science of medicine, patients also see technology as a normative and integral component of the medical encounter, especially at the extremes of life. In addition to its obvious role in preserving and enhancing human physiology, resuscitative technology itself may have a transcendent and as of yet largely unrealized role in the healing process While the archetypal performance of cardiopulmonary resuscitation (CPR) may parallel many older rituals, such technology is only a surrogate for true caring. As occasional cleric and scientist, the consummate clinician must promote their patient's interest first, and ultimately, balance the bivalent utility of CPR by recognizing both the value of its art and the limits of its science.Keywords: CPR, ritual, ethics, resuscitation, beneficenceTurkiye Klinikleri J Med Ethics 2004, 12:157-163
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