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Token resuscitation attempts on hopelessly ill patients prolong suffering
Date:11/1/2007

Resuscitating hopelessly ill patients too slowly to save their lives can be an invasive and undignified procedure that prolongs death and suffering, according to the November issue of Journal of Clinical Nursing.

Nursing ethics lecturer Jacinta Kelly, from Trinity College Dublin, has called for clinical and legal guidelines to be issued to prevent the practice of slow codes and highlighted the need for better communication about do not resuscitate (DNR) orders.

She hopes that this step will help healthcare professionals who often find themselves in a very difficult and unenviable position.

If a DNR order does not exist, healthcare professionals are expected to attempt resuscitation even if the patient is terminally ill she explains. Slow codes are seen as a way of going through the motions, being kinder to desperately ill patients and avoiding potential legal action. But it is unfair on the patient and also very difficult for staff who are keen to see patients end their life in a peaceful and dignified way.

Jacinta Kellys comments come after she carried out a review of international research into resuscitation covering more than 40 years. This underlined the changing face of end of life care with more people dying in hospital than home and the difficult legal and ethical dilemmas that medical advances bring for healthcare staff.

DNR orders are normally noted on a terminally ill patients chart and, as a result, no attempt is made to resuscitate them if they suffer a cardiac arrest she explains. However, it is clear from my research that, despite the availability of DNR orders, the grey area of slow codes - where healthcare professionals resuscitate a patient too slowly for their efforts to be successful is still an issue.

Patients need to give their consent for a DNR order to be put on their notes, but my review suggests that there are often reasons why this is not possible and slow codes end up being u
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Contact: Annette Whibley
wizard.media@virgin.net
Blackwell Publishing Ltd.
Source:Eurekalert

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