Do physicians require consent to withhold CPR that they determine to be nonbeneficial?

Downar, James; Close, Eliana; Sibbald, Robert

doi:10.1503/cmaj.191196

Cited by 9 publications

(2 citation statements)

References 7 publications

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“…In some jurisdictions, courts have ruled that physicians do not require consent to withhold CPR (or other lifesustaining measures) that they thought to be outside the standard of care. 23 Even within a single country, there…”

Section: Triage Protocolmentioning

confidence: 99%

Triage of Scarce Critical Care Resources in COVID-19 An Implementation Guide for Regional Allocation

Maves

Downar

Dichter

et al. 2020

Chest

Self Cite

253

174

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Endorsed by the American Association of Critical-Care Nurses and the Society of Critical Care Medicine Public health emergencies have the potential to place enormous strain on health systems. The current pandemic of the novel 2019 coronavirus disease has required hospitals in numerous countries to expand their surge capacity to meet the needs of patients with critical illness. When even surge capacity is exceeded, however, principles of critical care triage may be needed as a means to allocate scarce resources, such as mechanical ventilators or key medications. The goal of a triage system is to direct limited resources towards patients most likely to benefit from them. Implementing a triage system requires careful coordination between clinicians, health systems, local and regional governments, and the public, with a goal of transparency to maintain trust. We discuss the principles of tertiary triage and methods for implementing such a system, emphasizing that these systems should serve only as a last resort. Even under triage, we must uphold our obligation to care for all patients as best possible under difficult circumstances.

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Section: Triage Protocolmentioning

confidence: 99%

Triage of Scarce Critical Care Resources in COVID-19 An Implementation Guide for Regional Allocation

Maves

Downar

Dichter

et al. 2020

Chest

Self Cite

253

174

View full text Add to dashboard Cite

show abstract

“…In August 2019, in a landmark legal decision (Wawrzyniak v Livingstone), 2 Ontario Superior Court Justice Peter J. Cavanagh ruled in favour of 2 physicians who wrote a DNR order in a patient's chart and refused to start CPR for a patient despite the patient's SDM requesting it. 3 The ruling explained that in Ontario, an SDM makes decisions only on proposed treatments, and that CPR and intubation do not always need to be proposed as treatments if they are felt to not be medically indicated, such as in the context of imminent end of life or medical futility.…”

Section: Discussionmentioning

confidence: 99%