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Coding the Dead: Cardiopulmonary Resuscitation for Organ Preservation
Colin Eversmann1, Ayush Shah2, Christos Lazaridis3
1The MacLean Center for Clinical Medical Ethics, University of Chicago, Chicago, IL, USA.
AJOB Empirical Bioethics
|February 28, 2023
Summary
Clinicians generally agree that organ donor status should not influence cardiopulmonary resuscitation (CPR) decisions. However, there is division on requiring consent for CPR for organ preservation, especially after neurological determination of death.
Area of Science:
- Critical Care Medicine
- Bioethics
- Transplantation
Background:
- Lack of consensus exists in bioethics regarding cardiopulmonary resuscitation (CPR) for organ preservation.
- Perspectives of critical care clinicians are crucial for informing organ donor management policies.
Purpose of the Study:
- To assess critical care clinicians' perspectives on using CPR for organ preservation.
- To inform organ donor management policy and practice.
Main Methods:
- An anonymous online survey was distributed to members of the Society of Critical Care Medicine.
- Survey scenarios presented various situations regarding CPR for organ preservation.
Main Results:
- A majority of clinicians (81%) believe donation status should not influence CPR decisions for imminently dying patients.
- Strong agreement exists that CPR should be performed on registered donors with unknown code status before death by neurological criteria (DNC) and on non-donors before surrogate consent.
- Clinicians were divided on performing CPR after DNC for registered donors with undocumented code status (49% yes, 51% no) and on the need for consent for organ-preserving CPR (39% before DNC, 48% after DNC).
Conclusions:
- Most clinicians do not consider donor status relevant for CPR decisions before DNC.
- There is near-universal respect for 'Do Not Resuscitate' (DNR) orders in registered donors before DNC.
- Clinicians are divided on the necessity of affirmative consent for organ-preserving CPR both before and after DNC.
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