Biomaterial Database

Discussing cardiopulmonary resuscitation with elderly rehabilitation patients. Ethical and clinical considerations toward the formation of policy. 1993

J D Banja, and G S Bilsky

Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, Georgia.

Studies have demonstrated that most elderly persons who undergo cardiopulmonary resuscitation do not survive to hospital discharge. Because resuscitation efforts among elderly patients may fail either to restore hemodynamic stability or the patient's prearrest functional levels, ethical arguments as well as regulatory standards have urged the involvement of patients and their families in deciding about the advisedness of cardiopulmonary resuscitation. This article examines various ethical dimensions of conducting do-not-resuscitate discussions with competent, elderly persons in acute rehabilitation environments. Viewpoints that seek to excuse or resist do not resuscitate discussions among elderly rehabilitation consumers will be discussed as well as programmatic or psychological factors that appear to bolster such positions. These arguments, however, will be shown to be inferior to others that urge rehabilitation providers to engage their patients in frank and sincere discussions regarding their resuscitation status in the event of arrest.

UI	MeSH Term	Description	Entries
D010344	Patient Advocacy	Promotion and protection of the rights of patients, frequently through a legal process.	Patient Ombudsmen,Patient Representatives,Clinical Ombudsman,Patient Ombudsman,Advocacy, Patient,Ombudsman, Clinical,Ombudsman, Patient,Ombudsmen, Patient,Patient Representative,Representative, Patient,Representatives, Patient
D010358	Patient Participation	Patient involvement in the decision-making process in matters pertaining to health.	Patient Activation,Patient Empowerment,Patient Engagement,Patient Involvement,Patient Participation Rates,Activation, Patient,Empowerment, Patient,Engagement, Patient,Involvement, Patient,Participation Rate, Patient,Participation Rates, Patient,Participation, Patient,Patient Participation Rate
D012046	Rehabilitation	Restoration of human functions to the maximum degree possible in a person or persons suffering from disease or injury.	Habilitation
D012151	Resuscitation	The restoration to life or consciousness of one apparently dead. (Dorland, 27th ed)	Resuscitations
D003657	Decision Making	The process of making a selective intellectual judgment when presented with several complex alternatives consisting of several variables, and usually defining a course of action or an idea.	Credit Assignment,Assignment, Credit,Assignments, Credit,Credit Assignments
D004995	Ethics, Professional	The principles of proper conduct concerning the rights and duties of the professional, relations with patients or consumers and fellow practitioners, as well as actions of the professional and interpersonal relations with patient or consumer families. (From Stedman, 25th ed)	Professional Ethics,Ethic, Professional,Professional Ethic
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368	Aged	A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available.	Elderly
D017063	Outcome Assessment, Health Care	Research aimed at assessing the quality and effectiveness of health care as measured by the attainment of a specified end result or outcome. Measures include parameters such as improved health, lowered morbidity or mortality, and improvement of abnormal states (such as elevated blood pressure).	Assessment, Outcome,Outcome Assessment,Outcome Assessment (Health Care),Outcomes Research,Assessment, Outcomes,Outcome Measures,Outcome Studies,Outcomes Assessment,Assessment, Outcome (Health Care),Assessments, Outcome,Assessments, Outcome (Health Care),Assessments, Outcomes,Measure, Outcome,Measures, Outcome,Outcome Assessments,Outcome Assessments (Health Care),Outcome Measure,Outcome Study,Outcomes Assessments,Research, Outcomes,Studies, Outcome,Study, Outcome