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Slow codes as ethical disobedience.

Jason Adam Wasserman1,2,3,4

  • 1Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, Michigan, USA.

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Summary
This summary is machine-generated.

Healthcare providers sometimes use "slow codes" — intentionally delaying resuscitation efforts — to ethically manage futile or medically inappropriate interventions when patient or family demands conflict with best medical practice. This practice can be seen as an act of disobedience against an unjust system.

Keywords:
civil disobedienceethical disobediencefutilitymedical disobedienceshow codeslow code

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Area of Science:

  • Medical Ethics
  • Healthcare Policy
  • Clinical Practice

Background:

  • Patients or families may demand interventions that offer no benefit or are harmful.
  • Establishing a do not attempt resuscitation order can be challenging, even when cardiopulmonary resuscitation is medically inappropriate.
  • Legal challenges and conflicts can arise from disagreements over resuscitation status.

Purpose of the Study:

  • To explore the ethical justifications for the practice of "slow codes."
  • To examine the socio-political and clinical realities that lead to the use of slow codes.
  • To argue that slow codes can serve a moral purpose in the face of systemic issues.

Main Methods:

  • Literature review on "slow codes" and medical ethics.
  • Analysis of the conflict between patient/family demands and medical appropriateness.
  • Ethical argumentation regarding disobedience against perceived unjust systems.

Main Results:

  • Slow codes arise from the need to navigate conflicts regarding futile medical interventions.
  • The practice is widely criticized as unethical due to its inherent dishonesty.
  • Slow codes can be viewed as a moral act of resistance against an unethical system.

Conclusions:

  • Slow codes, while ethically contentious, may be motivated by complex clinical and systemic factors.
  • In contexts of perceived judicial and legislative overreach, slow codes can be interpreted as a moral act of disobedience.
  • Further discussion is needed to address the ethical dilemmas surrounding futile interventions and healthcare system constraints.