[3] The team will perform life saving measures, including CPR, in order to re-establish both cardiac and pulmonary function.
[7] This includes, among other cases: a patient in severe septic shock and/or multiple organ dysfunction syndrome whose organ damage cannot be contained and reversed any longer, one who has had an acute stroke that has irreversibly damaged vital brain functions needed for life beyond repair (i.e., in the brain stem), or who has advanced and incurable metastatic cancer, and one with severe pneumonia which is no longer treatable with assisted ventilation methods and medication, which all have very little or no realistic probability of success.
[8] A patient may request, in an advance directive, to prohibit certain responses, including intubation, chest compression, electrical defibrillation, or ACLS.
[11] The practice is "controversial from an ethical point of view",[12] as it represents a violation of a patient's trust and right "to be involved in inpatient clinical decisions".
[14] In 1987, New York became the first state in the United States to effectively end the practice by enacting legislation to require medical staff to honour a patient's refusal of cardiopulmonary resuscitation or a do not resuscitate order, and to grant civil and criminal immunity to those who do so or those who perform CPR without knowledge of the order.