Futility, appropriate care, and orders not to resuscitate: Who makes decisions and how?

Ethical issues in resuscitation arose once life-prolonging interventions advanced to the point where short-term cardiac resuscitation became plausible in patients in cases where imminent death was irreversible. The authors argue that ethical dilemmas arise from disputes over continued treatment when...

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Autores principales:	Christopher D. Lewis, Michael S. Ewer
Formato:	article
Lenguaje:	EN
Publicado:	South African Heart Association 2017
Materias:	resuscitation ethics Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/4d51a8fe65374c31a145bee4b975b17e
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spelling	oai:doaj.org-article:4d51a8fe65374c31a145bee4b975b17e2021-11-26T13:44:31ZFutility, appropriate care, and orders not to resuscitate: Who makes decisions and how?10.24170/7-4-19371996-67412071-4602https://doaj.org/article/4d51a8fe65374c31a145bee4b975b17e2017-04-01T00:00:00Zhttps://www.journals.ac.za/index.php/SAHJ/article/view/1937https://doaj.org/toc/1996-6741https://doaj.org/toc/2071-4602Ethical issues in resuscitation arose once life-prolonging interventions advanced to the point where short-term cardiac resuscitation became plausible in patients in cases where imminent death was irreversible. The authors argue that ethical dilemmas arise from disputes over continued treatment when stakeholders either disagree about the meaning of appropriate care as a result of differing beliefs on the meaning of an acceptable outcome and/or the extent of a treatment’s probable efficacy. The authors conclude that even though communication and transparency can help prevent these ethical dilemmas, unavoidable conflict over proper interventions should be resolved through a decision-making process grounded in both medical reality and the principles of patient self-determination. Thoughtful regulatory guidance can aid the understanding of rights and responsibilities when the desirability, efficacy, and medical indication of life-prolonging interventions are in dispute. The authors outline such a process. The authors suggest that seeking clear regulation in this arena is a worthwhile ethical and practical objective for physicians to reduce both the likelihood of conflicts and the burden of unavoidable conflicts despite transparency and communication.Christopher D. LewisMichael S. EwerSouth African Heart AssociationarticleresuscitationethicsDiseases of the circulatory (Cardiovascular) systemRC666-701ENSA Heart Journal, Vol 7, Iss 4, Pp 272-279 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	resuscitation ethics Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	resuscitation ethics Diseases of the circulatory (Cardiovascular) system RC666-701 Christopher D. Lewis Michael S. Ewer Futility, appropriate care, and orders not to resuscitate: Who makes decisions and how?
description	Ethical issues in resuscitation arose once life-prolonging interventions advanced to the point where short-term cardiac resuscitation became plausible in patients in cases where imminent death was irreversible. The authors argue that ethical dilemmas arise from disputes over continued treatment when stakeholders either disagree about the meaning of appropriate care as a result of differing beliefs on the meaning of an acceptable outcome and/or the extent of a treatment’s probable efficacy. The authors conclude that even though communication and transparency can help prevent these ethical dilemmas, unavoidable conflict over proper interventions should be resolved through a decision-making process grounded in both medical reality and the principles of patient self-determination. Thoughtful regulatory guidance can aid the understanding of rights and responsibilities when the desirability, efficacy, and medical indication of life-prolonging interventions are in dispute. The authors outline such a process. The authors suggest that seeking clear regulation in this arena is a worthwhile ethical and practical objective for physicians to reduce both the likelihood of conflicts and the burden of unavoidable conflicts despite transparency and communication.
format	article
author	Christopher D. Lewis Michael S. Ewer
author_facet	Christopher D. Lewis Michael S. Ewer
author_sort	Christopher D. Lewis
title	Futility, appropriate care, and orders not to resuscitate: Who makes decisions and how?
title_short	Futility, appropriate care, and orders not to resuscitate: Who makes decisions and how?
title_full	Futility, appropriate care, and orders not to resuscitate: Who makes decisions and how?
title_fullStr	Futility, appropriate care, and orders not to resuscitate: Who makes decisions and how?
title_full_unstemmed	Futility, appropriate care, and orders not to resuscitate: Who makes decisions and how?
title_sort	futility, appropriate care, and orders not to resuscitate: who makes decisions and how?
publisher	South African Heart Association
publishDate	2017
url	https://doaj.org/article/4d51a8fe65374c31a145bee4b975b17e
work_keys_str_mv	AT christopherdlewis futilityappropriatecareandordersnottoresuscitatewhomakesdecisionsandhow AT michaelsewer futilityappropriatecareandordersnottoresuscitatewhomakesdecisionsandhow
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Futility, appropriate care, and orders not to resuscitate: Who makes decisions and how?

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