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A third situation is one in which the medical staff deems that CPR will be of no clinical benefit to the patient.{{sfn|College of Physicians and Surgeons of Ontario|2006}} 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.{{sfn|Braddock|1998|loc=When is CPR not of benefit?}} There is also a low probability of success for patients with severe [[hypotension]] that resulted from shock or severe illness or injury, and has not responded to treatment (and which was not induced), severe cases of acute or chronic [[renal failure]] or [[end stage renal disease]] (where dialysis and other renal replacement therapies either are no longer working or were not adequate, and where a transplant either can't be found or is not an option), end-stage [[HIV/AIDS|AIDS]] and its accompanying severe opportunistic illnesses (which are not responding to antiretroviral and drug therapy and/or the white blood cell count is too low), or those who are older than about 70 and/or homebound (where they and/or their guardians, instead of a DNR order, have authorized such half measures and the law permits it).{{sfn|Braddock|1998|loc=When is CPR not of benefit?}}

 

 

==Ethics==