! This document was superseded by Decisions relating to Cardiopulmonary Resuscitation (3rd edition - 1st revision)
Guidance from the British Medical Association, the Resuscitation Council (UK), and the Royal College of Nursing (previously known as the "Joint Statement")
Background
The British Medical Association (BMA), the Resuscitation Council (UK), and the Royal College of Nursing (RCN) have issued new guidance regarding anticipatory decisions about whether or not to attempt resuscitation in a person when their heart stops or they stop breathing.
The new edition takes into account developments in clinical practice and developments in the law regarding anticipatory decisions about cardiopulmonary resuscitation (CPR). The fundamental ethical principles that underpin this guidance are unchanged.
In particular, the new edition:
- emphasises the importance of making anticipatory decisions about CPR as an integral part of good clinical practice: leaving people in the ‘default’ position of receiving CPR should they die, regardless of their views and wishes, denies them of the opportunity to refuse treatment that for many may offer no benefit and that many may not want;
- once again emphasises that every anticipatory decision about CPR must be based on assessment of the person’s individual circumstances at that time;
- emphasises the importance of involving people (or their representatives if they are unable to make decisions for themselves) in the decision-making process; this often involves a person making a shared decision with their healthcare professionals, but where CPR has no realistic chance of success it may involve informing people of the decision and explaining the basis for it;
- emphasises that when CPR has no realistic chance of success it is important to make decisions when they are needed, and not to delay a decision because a person is not well enough to have it explained to them or because their family or other representatives are not available; nevertheless a clear plan should be made to explain and discuss the decision with the person and/or their representatives at the earliest practicable opportunity;
- emphasises that, whenever possible, anticipatory decisions about CPR are best made well in advance, when people are well enough and have enough time to consider them carefully and discuss them fully with anyone that they wish to, including their family and members of their healthcare team;
- emphasises the increasing recognition that such advance decisions are often best made as part of a broader consideration of the type of care or treatments a person would wish to receive (as well as the type of care or treatments they would not wish to receive) should their health deteriorate so that they are unable to make choices for themselves
- emphasises the importance of careful documentation and effective communication of anticipatory decisions about CPR.
Decisions relating to cardiopulmonary resuscitation
October 2014
Decisions relating to cardiopulmonary resuscitation - new statement
November 2015
