Canadian family physician Médecin de famille canadien
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Where there are clear clinical indications that a patient suffering from a terminal illness would not benefit from cardiopulmonary resuscitation, there is no legal or ethical requirement that CPR be discussed with the patient as a treatment option or that CPR be administered if the patient stops breathing or suffers cardiac arrest.
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Talking with dying patients is different in some ways from talking with patients who do not have life-threatening illness; it can be frightening for physicians who have little experience. It is important to realize that, ultimately, the principles remain the same, and that the differences arise in the context and goals of the intervention. This article draws upon bedside experience to define several principles useful in talking with dying patients. Case examples illustrate each principle.