It happens all the time in a television medical drama. The patient goes into cardiac arrest due to drowning (or drug overdose or some other medical reason). The Good Samaritan or EMT verifies the person is nonresponsive and then begins CPR. Tense seconds past, the person gasps and then breathes again. The savior sits back, head hanging in relief. Real life is a little different from this, and estate planners need to be aware of the difference and how it affects the preparation of their clients’ end-of-life planning.
This prevalent television imagery caused a researcher to undertake a study in 1996 of how many people survived CPR intervention in medical shows that aired that year. The study showed that 75 percent of the time, the patient was revived. This gives people the idea that CPR works pretty well. Reality is different, however. A 2010 study of more than 95,000 cases (all of the cases of CPR in Japan that year) showed that only 8 percent of people revived by CPR survived for at least a month, and out of this 8 percent about 3 percent had a “good” outcome, i.e., returned to meaningful quality of life.
These studies and the issue of the general public’s misperception of CPR as an effective intervention were the subject of a recent episode of Radiolab, The Bitter End. The focus of the episode was the gap between what doctors would agree to as an intervention as opposed to what most people would want done to them. When doctors are asked to assume that they have brain damage or brain disease such that they cannot be cured, cannot recognize people, and cannot speak so people could understand them, 90 percent of the doctors said they would not want CPR or mechanical ventilation and 80 percent did not want a feeding tube, major surgery, or invasive testing. (The Precursors Study, Johns Hopkins). In contrast, say the producers of the Radiolab segment, the majority of the general population would agree to these interventions under the same circumstances.
These studies drive one to the conclusion that the general population would make different choices for end-of-life care if they were more informed. As an estate planner, you can help your client be more informed about the reality of the efficacy of these interventions. While the decision remains ultimately that of your client, you will know that you have provided your client with the tools to make an informed decision.