A critical review of the factors leading to cardiopulmonary resuscitation as the default position of hospitalized patients in the USA regardless of severity of illness
Abstract Background Physicians are occasionally faced with patients requesting full resuscitation against medical advice. More commonly, neither patients nor their family members make such a request, but physicians simply presume that providing cardiopulmonary resuscitation comports with the patient...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2019-03-01
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| Series: | International Journal of Emergency Medicine |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12245-019-0225-z |
| _version_ | 1818508230610911232 |
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| author | Loukas Georgiou Anastasios Georgiou |
| author_facet | Loukas Georgiou Anastasios Georgiou |
| author_sort | Loukas Georgiou |
| collection | DOAJ |
| description | Abstract Background Physicians are occasionally faced with patients requesting full resuscitation against medical advice. More commonly, neither patients nor their family members make such a request, but physicians simply presume that providing cardiopulmonary resuscitation comports with the patient’s wishes. In the USA, in contrast to other countries, a unilateral Do-Not-Resuscitate order by the physician is either forbidden by State Statute or not enforced by hospital policy. Unless otherwise specified, performing cardiopulmonary resuscitation on all hospitalized patients, regardless of the severity of the underlying illness, is the default position. Unlike other medical interventions, no deference is given to the medical judgment of the physician even when a patient is in the last days of a terminal illness. We examine the factors that have led to cardiopulmonary resuscitation having this unique status. Main body A review of the historical factors leading to cardiopulmonary resuscitation as the default position was undertaken. Articles published in the medical literature, lay-press articles, legislative enactments of law, and judicial opinions involving the issue of Do-Not-Resuscitate and cardiopulmonary resuscitation were reviewed regarding their impact on physician and hospital practice in the USA. Conclusion A critical review of the historical factors reveals that the rapid dissemination of cardiopulmonary training for the public, inaccuracies in the media regarding successful cardiopulmonary resuscitation, well-meaning legislative efforts with inadvertent consequences, and judicial interpretation outside the generally accepted concept of malpractice law have contributed to the situation faced by today’s physicians and hospitals in the USA. |
| first_indexed | 2024-12-10T22:28:49Z |
| format | Article |
| id | doaj.art-29aa82f0ecfa4bf0b0ad1e6df54ddad6 |
| institution | Directory Open Access Journal |
| issn | 1865-1372 1865-1380 |
| language | English |
| last_indexed | 2024-12-10T22:28:49Z |
| publishDate | 2019-03-01 |
| publisher | BMC |
| record_format | Article |
| series | International Journal of Emergency Medicine |
| spelling | doaj.art-29aa82f0ecfa4bf0b0ad1e6df54ddad62022-12-22T01:31:06ZengBMCInternational Journal of Emergency Medicine1865-13721865-13802019-03-011211910.1186/s12245-019-0225-zA critical review of the factors leading to cardiopulmonary resuscitation as the default position of hospitalized patients in the USA regardless of severity of illnessLoukas Georgiou0Anastasios Georgiou1Rhodes CollegeCarl Kirkland Cancer CenterAbstract Background Physicians are occasionally faced with patients requesting full resuscitation against medical advice. More commonly, neither patients nor their family members make such a request, but physicians simply presume that providing cardiopulmonary resuscitation comports with the patient’s wishes. In the USA, in contrast to other countries, a unilateral Do-Not-Resuscitate order by the physician is either forbidden by State Statute or not enforced by hospital policy. Unless otherwise specified, performing cardiopulmonary resuscitation on all hospitalized patients, regardless of the severity of the underlying illness, is the default position. Unlike other medical interventions, no deference is given to the medical judgment of the physician even when a patient is in the last days of a terminal illness. We examine the factors that have led to cardiopulmonary resuscitation having this unique status. Main body A review of the historical factors leading to cardiopulmonary resuscitation as the default position was undertaken. Articles published in the medical literature, lay-press articles, legislative enactments of law, and judicial opinions involving the issue of Do-Not-Resuscitate and cardiopulmonary resuscitation were reviewed regarding their impact on physician and hospital practice in the USA. Conclusion A critical review of the historical factors reveals that the rapid dissemination of cardiopulmonary training for the public, inaccuracies in the media regarding successful cardiopulmonary resuscitation, well-meaning legislative efforts with inadvertent consequences, and judicial interpretation outside the generally accepted concept of malpractice law have contributed to the situation faced by today’s physicians and hospitals in the USA.http://link.springer.com/article/10.1186/s12245-019-0225-zDo-Not-ResuscitateCardiopulmonary resuscitationPresumed consentFutilityMedicolegal |
| spellingShingle | Loukas Georgiou Anastasios Georgiou A critical review of the factors leading to cardiopulmonary resuscitation as the default position of hospitalized patients in the USA regardless of severity of illness International Journal of Emergency Medicine Do-Not-Resuscitate Cardiopulmonary resuscitation Presumed consent Futility Medicolegal |
| title | A critical review of the factors leading to cardiopulmonary resuscitation as the default position of hospitalized patients in the USA regardless of severity of illness |
| title_full | A critical review of the factors leading to cardiopulmonary resuscitation as the default position of hospitalized patients in the USA regardless of severity of illness |
| title_fullStr | A critical review of the factors leading to cardiopulmonary resuscitation as the default position of hospitalized patients in the USA regardless of severity of illness |
| title_full_unstemmed | A critical review of the factors leading to cardiopulmonary resuscitation as the default position of hospitalized patients in the USA regardless of severity of illness |
| title_short | A critical review of the factors leading to cardiopulmonary resuscitation as the default position of hospitalized patients in the USA regardless of severity of illness |
| title_sort | critical review of the factors leading to cardiopulmonary resuscitation as the default position of hospitalized patients in the usa regardless of severity of illness |
| topic | Do-Not-Resuscitate Cardiopulmonary resuscitation Presumed consent Futility Medicolegal |
| url | http://link.springer.com/article/10.1186/s12245-019-0225-z |
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