Sudden cardiac death ethical issues

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Edzel Lorraine Co, DMD, MD[2]

Ethical Issues

Cardiopulmonary resuscitation (CPR) and advanced cardiac life support (ACLS) are not always in a person's best interest. This is particularly true in the case of terminal illnesses when resuscitation will not alter the outcome of the disease. Properly performed CPR often fractures the rib cage, especially in older patients or those suffering from osteoporosis. Defibrillation, especially repeated several times as called for by ACLS protocols, may also cause electrical burns.

Some people with a terminal illness choose to avoid such measures and die peacefully. People with views on the treatment they wish to receive in the event of a cardiac arrest should discuss these views with both their doctor and with their family. A patient may ask their doctor to record a do not resuscitate (DNR) order in the medical record. Alternatively, in many jurisdictions, a person may formally state their wishes in an advance directive or advance health directive.

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