Dr. Signout, over at, well, Signout, wrote an interesting piece the other day. It’s a piece that everyone should read and think about while they can, because you never know when you may need to think about this.
One of the most dramatic procedures in any hospital is the CPR, also known as a “code blue”, or simply a “code”. This is the choreographed chaos that takes place when someone’s cardiopulmonary status deteriorates to the point that only immediate and violent intervention will prevent their death. To put it more dramatically, the object of a code is often to forestall or even reverse death. Health care providers hold a range of opinions about whether or not family members should be allowed to witness a code. Current ACLS guidelines take a reasonable, evidence-based approach:
[I]n the absence of data documenting harm and in light of data suggesting that it may be helpful, offering select family members the opportunity to be present during a resuscitation seems reasonable and desirable (assuming that the patient, if an adult, has not raised a prior objection. Parents and other family members seldom ask if they can be present unless encouraged to do so by healthcare providers. Resuscitation team members should be sensitive to the presence of family members during resuscitative efforts, assigning a team member to the family to answer questions, clarify information, and otherwise offer comfort.
Some would argue that doctors have never given up their death-grip on paternalism, but I have argued otherwise. In the case of codes, however, paternalism may still hold sway, at least in a certain way.
Continue reading “I wish we’d talked about this earlier…”