To resuscitate or not to resuscitate – the crossroads of ethical decision-making in resuscitation in the emergency department
Introduction: Emergency physicians (EPs) working in low-resource settings, where patients mainly bear healthcare delivery, face many challenges. Emergency care is patient-centered and ethical challenges are numerous in situations where patient autonomy and beneficence are fragile. This review discusses some of the common bioethical issues in the resuscitation and post-resuscitation phases of treatment, it proposes solutions and emphasizes the necessity for evidence-based ethics and unanimity on ethical standards.
Methods: After consensus was reached on the article's structure, smaller groups of authors (2-3) wrote narrative reviews of ethical issues like patient autonomy and honesty, beneficence/nonmaleficence and dignity, justice, and specific practices/circumstances like family presence during resuscitation after having discussions with senior EPs. Ethical dilemmas were discussed, and solutions were proposed.
Results: The cases related to medical decision-making by proxies, financial constraints in management, and resuscitation in the face of medical futility have been discussed. Solutions proposed include involving hospital ethics committees early on, having financial mechanisms in place beforehand, and allowing some leverage on a case-to-case basis when care is futile.
Conclusion: We recommend developing evidence-based national ethical guidelines and incorporating societal and cultural norms with autonomy, beneficence, non-maleficence, honesty, and justice principles
Publication ( Name of Journal)
Clinical and Experimental Emergency Medicine
(2023). To resuscitate or not to resuscitate – the crossroads of ethical decision-making in resuscitation in the emergency department. Clinical and Experimental Emergency Medicine.
Available at: https://ecommons.aku.edu/pakistan_fhs_mc_emerg_med/336