Resuscitation in the A & E department: can concepts of death aid decision making?

The expectations of modern society may not recognize the limitations of technical medicine. This is particularly evident when considering the ethical problems faced by practitioners regarding the continuation or withdrawal of cardiopulmonary resuscitation within the Accident and Emergency department. This paper contends that concepts of death and our technical and cultural understanding of these must be more clearly defined and may then assist in the process of decision making. Clarifying our understanding of death, which is relevant to this clinical environment, provides us with a realistic goal for intervention. Heroic measures merely instill false hopes. A more precise delineation between cardiac arrest and death may then guide decision making, elaborate our clinical and moral perspectives on the situation and may ease the moral burdens of this complex and sensitive aspect of practice.