This document discusses some of the key ethical issues surrounding cardiopulmonary resuscitation (CPR). It outlines the goals of resuscitation as restoring health, preserving life, relieving suffering, and respecting individual decision rights. Resuscitation decisions are guided by science, individual patient preferences, surrogate preferences, local policies, and legal requirements. When providing CPR, healthcare professionals should consider ethical principles like respect for autonomy, non-maleficence, beneficence, futility, and justice. They must play a role in resuscitation decision making and uphold patients' medical preferences.

1. ETHICAL ISSUES IN BLS
BY KONDUTO G. O.

2. INTRODUCTION
Resuscitation has goals and also operates within some ethical
framework that is important to the care provider, patient family and
society
Resuscitation goals;
 Restore health.
 Preserve life.
 Relieve suffering.
 Respect individual decision right and privacy.

3. CT’S
Ethical framework a round or within which resuscitation operates as
far as decision for resuscitation is concerned are;
 Science guided
 Individual patient preference
 Surrogate preference for incapacitated patients
 Local policy
 Legal requirement

4. ETHICAL PRINCIPLES
Health care professionals should consider ethical, legal and
cultural factors when caring for the patient that need CPR
They must play a role in resuscitation decision making.

5. CT’S
The principles include
1. Respect for autonomy
2. Principle of futility.
3. Beneficence
4. Non-maleficence
5. justice

6. RESPECT FOR AUTONOMY
 This is respecting the healthcare preference or decision of the
patient
 This follows patient ability to make competent decision on his
health
 Adult are presumed to have decision making capability unless
declared incapacitated by court of law
 For them to be presumed so ,they should be able to understand
their condition prognosis nature of proposed care benefit of care
treatment and risk

7. Decision making process.
 Care provider should give accurate information about ythe
condition prognosis nature of care, alternative care benefits and
risks associated
 The patient the allow/ asked to paraphrase the accurate
information given to enable the care provider assess his/her
understanding. In case of misunderstanding correction is done to
ensure proper understanding
 The patient then allowed to make his/her treatment decision and
justify why a particular preference is made. That competent
decision is to be respected

8. CT’S
 When decision making capacity is impaired by factors such
as illness and preference is unknown, emergency
treatment should continue until the information is
available
 Legal documents that protect the principle of respect for
autonomy is called Advance directive ( LIVING WILL,
DNAR order, surrogate decision maker)

9. PRINCIPLE OF FUTILITY
 Futile treatment is administration of treatment that is not
beneficial to a patient.
 Health care providers are not obliged administer such
treatment.

10. CT’S
 Example of futile treatment is performing a CPR on a
patient who has suffered a irreversible death or delivering
compressions that you know are ineffective to indicate
your effort to have done resuscitation.
 Another example is continuous administration of drugs
you know is not going to help the patient as the patient
deteriorate to death.

11. 3. BENEFICENCE
 Beneficence is doing good to a patient.
 Philosophy of palliative care reminds us about maximizing
persons quality of life by relieving pain and suffering.
 Holding this ethical principle will help the patient meet a
comfortable end of life experience full of dignity.

12. 4. NON-MALEFICENCE
 Non-maleficence means do not harm the patients
 Any time a physician withhold or withdraw futile
treatment, he or he should uphold this ethical principle.
 With the scares resources and high demand couple with
pressure of standard care, the above ethical principle
should be upheld

13. 5. JUSTICE
 Justice means fairness.
 In this context, it is fairness during resuscitation.
 With high demand and pressure, you are required by this
ethical principle to be fair and distribute available service
to ala by standard.

14. WITHHOLDING AND WITHDRAWING CPR
 Withholding is not giving the service/care knowingly to
the patient
 Withdrawing is stopping the care that you had started on
a patient.

15. REASONS FOR WITH HOLDING
 Situations where attempts to do CPR would place the rescuer at
risk
 Obvious signs of irreversible death (decomposition, decapitation or
head cut off, )
 A valid signed and dated advance directive indicating DNAR

16. WHEN TO STOP RESUSCITATION
 ROSC.
 After 2ominutes of CPR without response or shockable rhythm.
 Care transferred to ACLS team
 Unable to continue because of exhaustion or else you will be a
victim
 Reliable criteria indicating irreversible death.