[Let »Do-Not-Attempt-Cardiopulmonary Resuscitation« decisions  be well grounded]

Ethical decisions such as "Do-Not-Attempt -Cardiopulmonary Resuscitation" (DNACPR) are much more common than actual resuscitation attempts of an in-hospital cardiac arrest (IHCA). Currently, no risk profiles for who will suffer an IHCA exit, neither has any published prediction model for survival after IHCA been accurate enough for clinical implementation. Swedish law implies that we should consult patients and/or relatives and a licensed colleague when making these decisions, which currently is fulfilled in a minority of the patients. Frailty has emerged as a strong predictor of outcome after IHCA. However, a recent study performed by the authors has shown preserved neurological function in 87% of frail patients suffering IHCA. This challenges the concept of identifying what lies in the best interest of the patient. Let DNACPR decisions be well-grounded with thorough assessment of prognosis, balanced against the patients' values and in consultation with another licenced caregiver.