I hope this isn't too off-topic but I would like to know what your thoughts are on the MPDS system used by most North American Ambulance Services. I'm minly interested in what you think of the Post Dispatch Medical instructions that the call taker gives over the phone. I refer specifically to cases of the elderly who have long standing chronic and in some cases terminal illnesses, unless the family has a signed and current DNA order, the call taker must give CPR instruction over the phone and in many cases, it is the elderly spouse who must perform CPR. The current MPDS questions do not illicit enough information about the length of time the patient has been VSA or the patient's medical history and unless the elderly spouse volunteers information such as he is cold to the touch or can't extend his jaw because rigor has set in, then CPR will be initiated. In instances where the family has been expecting the demise of the patient, I think it is cruel and emotionally traumatic to expect them to start CPR and also robs the patient of a peaceful and dignified death.