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Ethical and end-of-life issues after cardiac arrest 

Ethical and end-of-life issues after cardiac arrest
Chapter:
Ethical and end-of-life issues after cardiac arrest
Author(s):

Carolyn Benson

and G. Bryan Young

DOI:
10.1093/med/9780199600830.003.0067
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date: 24 February 2020

Many survivors of cardiac arrest, especially out-of-hospital cardiac arrest, suffer varying degrees of anoxic-ischaemic brain injury. Accurate neurological prognostication to determine which patients will have poor neurological outcome is important to guide appropriate medical care and advise surrogate decision makers. Accurate prognostication generally requires the presence of two or more negative prognostic indicators, especially following treatment with therapeutic hypothermia. Medical care should be directed at achieving survival that the patient would consider acceptable. Poor quality survival is generally defined as severe disability with full dependency, minimally-conscious, or vegetative state. Discussions regarding prognosis and management of patients who remain unresponsive after resuscitation from cardiac arrest should be conducted in a professional manner and show respect for the individuals involved, their culture, and religion.

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