Moral dilemmas and slow codes.

Area of Science:

• Medical Ethics
• Moral Psychology
• Clinical Decision-Making

Background:

• Slow codes are generally considered morally impermissible in medicine and medical ethics.
• The decision-making process for slow codes shares similarities with complex moral dilemmas like the trolley problem.

Purpose of the Study:

• To argue for the moral permissibility of slow codes using insights from moral psychology.
• To demonstrate that slow codes can be the optimal choice in specific clinical situations, particularly when faced with requests for futile cardiopulmonary resuscitation (CPR).

Main Methods:

• Analysis of the slow code decision-making context through the lens of moral psychology.
• Comparison of the slow code dilemma to the trilemma framing of the trolley problem.
• Addressing common objections to the practice of slow codes.

Main Results:

• The decision-making context for slow codes is analogous to the trolley problem trilemma.
• In situations analogous to the trolley problem's best choice, slow codes may be the best option for futile CPR requests.
• Resistance to slow codes stems from psychological factors rather than the act's inherent moral properties.

Conclusions:

• Slow codes are not only morally permissible but potentially the best option in certain clinical scenarios involving futile CPR.
• Understanding moral psychology can reframe the ethical permissibility of slow codes.
• Factors such as emotion and personal force influence judgments about slow codes, not their ethical standing.