Jump to content

Slow code

Add links
From Wikipedia, the free encyclopedia
This is an old revision of this page, as edited by 2601:245:8200:611e:85c3:6e9:5e37:6d23 (talk) at 00:09, 2 August 2019. The present address (URL) is a permanent link to this revision, which may differ significantly from the current revision.
This article is about the medical practice. For the programming term, see algorithmic efficiency.

Slow code refers to the practice in a hospital or other medical centre to purposely respond slowly or incompletely to a patient in cardiac arrest, particularly in situations for which cardiopulmonary resuscitation (CPR) is of no medical benefit.[1] The related term show code refers to the practice of a medical response that is medically futile, but is attempted for the benefit of the patient's family and loved ones. However, the terms are often used interchangeably.[1]

The practices are banned in some jurisdictions.

Ethics

The practice is "controversial from an ethical point of view",[2] as it represents a violation of a patient's trust and right "to be involved in inpatient clinical decisions".[3]

In a position paper, the American Nurses Association states that "slow codes are not ethical".[4]

Policy and legislation

Some medical services centres have instituted policy banning the practice.[5]

In 1987, New York became the first state in the United States to effectively end the practice by enacting legislation to require medical staff to honour a patient's refusal of cardiopulmonary resuscitation or a do not resuscitate order, and to grant civil and criminal immunity to those who do so or those who perform CPR without knowledge of the order.[1]

Notes

  1. ^ a b c New York Times 1987.
  2. ^ DePalma et al. 1999.
  3. ^ Braddock 1998, What if the family disagrees with the DNR order?.
  4. ^ ANA Center for Ethics and Human Rights 2012, p. 6.
  5. ^ Braddock 1998, What about "slow codes"?.

References

  • Braddock, Clarence H. (1998). "Do Not Resuscitate Orders". Ethics in Medicine. University of Washington School of Medicine. Retrieved 2013-04-06. {{cite web}}: Invalid |ref=harv (help)
  • Berger, Jeffrey T. (October 2003). "Ethical Challenges of Partial Do-Not-Resuscitate (DNR) Orders". Archives of Internal Medicine. 163 (19): 2270–2275. doi:10.1001/archinte.163.19.2270. PMID 14581244. {{cite journal}}: Invalid |ref=harv (help)
  • DePalma, Judith A.; Miller, Scott; Ozanich, Evelyn; Yancich, Lynne M. (November 1999). ""Slow" Code: Perspectives of a Physician and Critical Care Nurse". Critical Care Nursing Quarterly. 22 (3). Lippincott Williams and Wilkins: 89–99. doi:10.1097/00002727-199911000-00014. ISSN 1550-5111. {{cite journal}}: Invalid |ref=harv (help)
  • Dosha, Kristofer; Dhoblea, Abhijeet; Evonicha, Rudolph; Guptaa, Amit; Shaha, Ibrahim; Gardiner, Joseph; Dwamenaa, Francesca C. (September 2009). "Analysis of limited resuscitations in patients suffering in-hospital cardiac arrest". Resuscitation. 80 (9): 985–989. doi:10.1016/j.resuscitation.2009.05.011. {{cite journal}}: Invalid |ref=harv (help)
  • Marks, William J. (1 January 2006). ""Code Blue", "Code Black": What Does "Code" Mean?". WebMD. Retrieved 2013-04-06. {{cite web}}: Invalid |ref=harv (help)
  • "Nursing Care and Do Not Resuscitate (DNR) and Allow Natural Death (AND) Decisions" (PDF). ANA Center for Ethics and Human Rights. American Nurses Association. 12 March 2012. Retrieved 2013-04-06.{{cite web}}: CS1 maint: others (link)
  • "Decision-making for the End of Life". Physician Advisory Service. College of Physicians and Surgeons of Ontario. May 2006. Retrieved 2013-04-06.{{cite web}}: CS1 maint: others (link)
  • "Hospitals' 'code blue' most deadly at night". Chicago: NBC News. Associated Press. 19 February 2008. Retrieved 2013-04-06.
  • "Slow Codes, Show Codes and Death". New York Times. New York Times Company. 22 August 1987. Retrieved 2013-04-06.
Retrieved from "https://en.wikipedia.org/w/index.php?title=Slow_code&oldid=908938559"