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Healthcare professionals are ethically obliged to do all they can to ensure the survival of their patients.
But in some instances, some physicians are willing to go the extra mile and attempt to perform CPR on a patient even though they know there’s absolutely no hope of survival, The Messenger reports, a practice that has become known as “slow codes” or “show codes.”
It’s a thorny debate when it comes to patients who haven’t signed a Do Not Resuscitate order, or have family members who insist on having their loved one receive care until the very end.
Then there’s the possibility of actually doing more harm than good, causing even more pain for patients who are actively dying. CPR, in particular, has become the default treatment for many patients who are seriously ill, despite a nearly 85 percent failure rate. The practice can also impart a significant amount of physical harm, including fractured ribs or punctured lungs.
Despite “slow codes” being a fairly common practice, the taboo surrounding it has persisted over the years. To get a better grasp of the situation, the journal Bioethics is asking expertsto weigh in on the topic for an upcoming issue.
In a 2021 paper published in the Journal of Pain and Symptom Management, practitioners expressed some seriously mixed feelings about the ethics of slow codes, with most respondents feeling uneasy about being asked to resuscitate in a medically futile case. According to The Messenger, some hospitals have even prohibited the practice entirely.
“Even if they are dying, it might worsen their death,” Parker Crutchfield, an adjunct assistant professor of philosophy at Western Michigan University and a co-editor at Bioethics, told The Messenger.
On the other hand, making it look like a given patient received the utmost care could actually be helpful.
“But it also, when done insincerely, can also do a lot of good for families,” Crutchfield added.
Experts are now hoping to find a consensus on what’s best, setting up some clear guidelines on what to do in the possible case of a slow code.
“You have to make a judgment about what really is futile, and what really is in somebody’s best interest,” Arthur Caplan, professor of bioethics at New York University, told The Messenger. “And that’s not written down in any guidelines.”
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