2. Withhold "ordinary" measures

Cardiopulmonary resuscitation and antibiotics are not "extraordinary" or "heroic" measures. Lots of ordinary citizens have learned CPR techniques; and antibiotics like penicillin are plentiful, cheap, and have relatively few side-effects. So they are clearly "ordinary" measures in the terms of the definition below:

ORDINARY MEASURES =df all medicines, treatments, and operations which offer a reasonable hope of benefit and which can be obtained and used without excessive expense, pain, or other inconvenience
[Gerald Kelly, "Notes: The Duty to Preserve Life," Theological Studies 12 (1951):550-556.]

And yet patients in the last stages of terminal illness may appropriately decide (e.g.) that they would not want to be resuscitated if they should suffer a cardiac arrest.

More controversially, think of a patient who has been in a coma for months or years, with no prospect of ever regaining consciousness (e.g., Karen Quinlan), who then develops pneumonia. Would it be appropriate to forego antibiotic treatment that would restore her to her previous state? A few generations ago, pneumonia was called "the old man's friend," because it is a relatively painless way to die.

EXAMPLES

• CPR - cardiopulmonary resusciatation

• antibiotics when pneumonia develop