Should the "slow code" be resuscitated?

Area of Science:

• Medical Ethics
• Bioethics
• End-of-Life Care

Background:

• The practice of "slow codes," or performing less than full cardiopulmonary resuscitation (CPR), is widely condemned by bioethicists and medical professional societies.
• Ethical guidelines and medical literature frequently describe slow codes as deceptive, dishonest, and unethical.

Purpose of the Study:

• To explore the ethical defensibility of slow codes in specific end-of-life scenarios.
• To argue for the appropriateness of slow codes when CPR is futile and families struggle with do-not-resuscitate (DNR) orders.

Main Methods:

• Ethical analysis of the practice of slow codes.
• Discussion of physician communication strategies in end-of-life care.

Main Results:

• Slow codes are generally considered unethical due to deception.
• However, in cases of likely CPR ineffectiveness and family difficulty with DNR orders, slow codes may be ethically permissible.

Conclusions:

• Physicians may ethically employ slow codes when CPR is futile and families are unable to consent to a DNR order.
• Ambiguous communication and less vigorous resuscitation can serve patient and family best in these complex situations.