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Family presence during cardiopulmonary resuscitation: who should decide?
  1. Zohar Lederman1,
  2. Mirko Garasic2,3,
  3. Michelle Piperberg4
  1. 1Yale Interdisciplinary Center for Bioethics, New Haven, Connecticut, USA
  2. 2Center for Human Bioethics, Monash University, Melbourne, Australia
  3. 3Center for Ethics and Global Politics, LUISS University, Rome, Italy
  4. 4Department of Theoretical and Practical Philosophy, Faculty of Philosophy, University of Barcelona, Barcelona, Spain
  1. Correspondence to Zohar Lederman, Institution for Social and Policy Studies, Yale Interdisciplinary Center for Bioethics, PO Box 208293, New Haven, Connecticut 06520-8293, USA; zoharlederman{at}gmail.com

Abstract

Whether to allow the presence of family members during cardiopulmonary resuscitation (CPR) has been a highly contentious topic in recent years. Even though a great deal of evidence and professional guidelines support the option of family presence during resuscitation (FPDR), many healthcare professionals still oppose it. One of the main arguments espoused by the latter is that family members should not be allowed for the sake of the patient's best interests, whether it is to increase his chances of survival, respect his privacy or leave his family with a last positive impression of him. In this paper, we examine the issue of FPDR from the patient's point of view. Since the patient requires CPR, he is invariably unconscious and therefore incompetent. We discuss the Autonomy Principle and the Three-Tiered process for surrogate decision making, as well as the Beneficence Principle and show that these are limited in providing us with an adequate tool for decision making in this particular case. Rather, we rely on a novel principle (or, rather, a novel specification of an existing principle) and a novel integrated model for surrogate decision making. We show that this model is more satisfactory in taking the patient's true wishes under consideration and encourages a joint decision making process by all parties involved.

  • Applied and Professional Ethics
  • Autonomy
  • Care of the Dying Patient
  • Clinical Ethics
  • Rights

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