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Cracking the code of the slow code: A taxonomy of slow code practices and their clinical and ethical implications
Erica Andrist1,2, Jacqueline Meadow2,3,4, Nurah Lawal2,5
1Division of Pediatric Critical Care Medicine, C.S. Mott Children's Hospital, Ann Arbor, Michigan, USA.
None:
The ethical permissibility of the "slow code" sparks vigorous debate. However, definitions of the "slow code" that exist in the literature often leave room for interpretation. Thus, those assessing the ethical permissibility of the slow code may not be operating with shared definitions, and definitions may not align with clinicians' understanding and use of the term in clinical practice. To add clarity and nuance to discussions of the "slow code," this manuscript highlights the salient medical and moral components that distinguish resuscitative practices, resulting in a taxonomy that includes nine distinct entries: the Fake Code, Casual Code, Time-Limited Code, Family Code, Contained Code, a la Carte Code, Preventive Code, Passive Code, and Accepted Code. We argue that cogent analyses of the ethical implications of the "slow code" must begin with clear, shared understandings of the practices under debate.
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