Affiliations 

  • 1 Department of Emergency Medicine, Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O. Box 653, 84105, Beer-Sheva, Israel. ozerj@post.bgu.ac.il
  • 2 Shalvata Mental Health Center, Hod Hasharon, Israel and Sakler School of Medicine, Tel Aviv University, Tel Aviv, Israel
  • 3 PREPARED Center for Emergency Response Research, Ben-Gurion University of the Negev, Beer-Sheva, Israel
  • 4 Foundation Surgical Hospital of Houston, Houston, TX, USA
  • 5 Intensive Care Unit, Shaare Zedek Medical Center, Jerusalem, Israel and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
BMC Med Ethics, 2019 12 26;20(1):102.
PMID: 31878920 DOI: 10.1186/s12910-019-0439-x

Abstract

BACKGROUND: The ethical principle of justice demands that resources be distributed equally and based on evidence. Guidelines regarding forgoing of CPR are unavailable and there is large variance in the reported rates of attempted CPR in in-hospital cardiac arrest. The main objective of this work was to study whether local culture and physician preferences may affect spur-of-the-moment decisions in unexpected in-hospital cardiac arrest.

METHODS: Cross sectional questionnaire survey conducted among a convenience sample of physicians that likely comprise code team members in their country (Indonesia, Israel and Mexico). The questionnaire included details regarding respondent demographics and training, personal value judgments and preferences as well as professional experience regarding CPR and forgoing of resuscitation.

RESULTS: Of the 675 questionnaires distributed, 617 (91.4%) were completed and returned. Country of practice and level of knowledge about resuscitation were strongly associated with avoiding CPR performance. Mexican physicians were almost twicemore likely to forgo CPR than their Israeli and Indonesian/Malaysian counterparts [OR1.84 (95% CI 1.03, 3.26), p = 0.038]. Mexican responders also placed greater emphasison personal and patient quality of life (p 

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.