CPR Rates among Elderly and Minorities

Rosemary Flanigan
Distinguished Fellow
Center for Practical Bioethics

October 16, 2009

A July 2, 2009 article in the New England Journal of Medicine suggests NO improvement in elderly survival following CPR from ’92-’05; in-hospital deaths preceded by CPR increased, and the proportion of survivors discharged home after undergoing CPR decreased.

And the article associates higher rates of CPR but lower rates of survival after CPR to race. That is most interesting, I think. Justice denied over the centuries is most apparent today in the lack of trust in the healthcare system shown by blacks—shown here in their expectations of CPR as has been shown elsewhere in their low rate of advance directive planning. Talk about complexity!

The journal article ends: “This study provides information useful to older patients and their clinicians in their decision about whether to choose to be resuscitated, since the proportion of elderly patients who choose resuscitation is directly related to the probability of survival that is presented to these patients. Our findings also provide a stimulus to understand the association between race and survival, with the goals of not only eliminating racial disparities in the quality of medical care but also understanding factors associated with the incidence of CPR and the rate of survival after CPR for patients of all races.”

What if an ethics committee invited some emergency room professionals to a short meeting in which this article is discussed? What if the committee invited some GPs to the same meeting?

Facts don’t always change moral assumptions, but sometimes they do.