Human Exceptionalism

When In Doubt, Resuscitate

The case of the nurse who refused CPR to an elderly woman continues to ricochet around the media and culture. I have heard people bend over backwards to say the nurse was right, because–well because.

The family says she didn’t want CPR. But the nurse at the independent living center certainly didn’t seem to know that. If she did, why call 911, and indeed, why not tell the 911 operator that the woman had an advance directive stating no resuscitation? To the contrary, from everything I have read–and I still think there should be an investigation–it would appear that the facility had a blanket “No CPR” policy that the nurse was following so she wouldn’t lose her job. Was that the cost of residential admission?

Beyond the specifics of the case, the question becomes when should CPR be attempted and when not?  Certainly there are cases in which it should and when it shouldn’t. In this regard, an article in the Huffington Post by Janice Van Dyck asks, “Do We Have a Duty to Resuscitate?” She concludes:

Do we have a duty to perform CPR? Not in my mind. The only obligation I can see all of us having is to know what we want at the time of our deaths and to advise those closest to us and our medical providers of our decisions. Advance care directives, health care surrogates, physician orders for life sustaining treatments (POLST), and do not resuscitate orders (DNR) are the vehicles for us to remove the questions and provide the answers so our names don’t make the headlines tomorrow.

That certainly applies in controlled situations. But what about outside of a hospital or nursing home: When in doubt, what should the duty be? I say, resuscitate. The 87-year old woman’s life must be viewed as just as important as anyone else’s. 

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