Document Detail


Clinical model for ethical cardiopulmonary resuscitation decision-making.
MedLine Citation:
PMID:  22646807     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Decisions to withhold cardiopulmonary resuscitation (CPR) for future cardiac arrest continue to be problematic, with a lack of consistency in how doctors approach this decision.
AIMS: To develop a clinical model that can be used in education to improve consistency in CPR decision-making.
METHODS: A qualitative study, using semistructured interviews with a total of 33 senior doctors, junior doctors and nurses from two Melbourne hospitals explored how decisions to withhold CPR are made. Interviews explored: issues arising; how doctors learn to make these decisions; how they deal with disagreement and their experiences of performing CPR. The transcripts were coded and analysed thematically.
RESULTS: Three major themes were identified: CPR as a life-and-death decision; good and bad dying; and trust. The research also defined the two elements to a CPR decision: (i) technical and (ii) ethical.
CONCLUSIONS: Applying ethical principles commonly used in medicine, a model for ethical CPR decision-making has been developed that identifies four patient groups, each with a different discussion aim. This approach simplifies the complexities of the CPR decision, providing a structured way to teach CPR decision-making to doctors and thereby achieve greater consistency in the decisions made.
Authors:
B Hayes
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Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  Internal medicine journal     Volume:  43     ISSN:  1445-5994     ISO Abbreviation:  Intern Med J     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-01-17     Completed Date:  2013-07-01     Revised Date:  2013-09-26    
Medline Journal Info:
Nlm Unique ID:  101092952     Medline TA:  Intern Med J     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  77-83     Citation Subset:  IM    
Copyright Information:
© 2012 The Author; Internal Medicine Journal © 2012 Royal Australasian College of Physicians.
Affiliation:
Advance Care Planning Program, Northern Health and School of Population Health, The University of Melbourne, Melbourne, Victoria, Australia. barbara.hayes@nh.org.au
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MeSH Terms
Descriptor/Qualifier:
Attitude to Death
Cardiopulmonary Resuscitation / ethics*
Decision Support Techniques*
Heart Arrest / therapy
Hospitals, Urban
Humans
Interviews as Topic
Medical Futility
Medical Staff, Hospital / psychology
Negotiating
Nurses / psychology
Patient Preference
Physician-Patient Relations
Physicians / psychology
Professional-Family Relations
Qualitative Research
Resuscitation Orders / ethics*
Trust
Victoria
Comments/Corrections
Comment In:
Intern Med J. 2013 Aug;43(8):956   [PMID:  23919344 ]
Intern Med J. 2013 Aug;43(8):956-7   [PMID:  23919345 ]
Intern Med J. 2013 Aug;43(8):957-8   [PMID:  23919346 ]

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