Performing Futile CPR Revisited

The May 27 issue of the New England Journal of Medicine has seven Letters to the Editor about Dr. Robert Truog’s February 11 article, “Is It Always Wrong to Perform Futile CPR?”

I’ve used that case with two ethics brown bag sessions and found the groups siding with Dr. Truog, much to my amazement.

The letters here lean toward the futility of the project and Dr. T replies, saying that “the pristine ethic of ‘treat only the patient, not the family’” is “simplistic” and “may not do justice to the complex dynamics that are often at play in end-of-life care.”

My two groups would agree!

-- Rosemary Flanigan, PhD, Distinguished Fellow, Center for Practical Bioethics

Yes, I think there are many of us who want clinicians to care for (which is maybe better terminology than “treat”) families and even communities, and not individual patients only.

The question that this does not answer, and Dr Truog doesn’t either, is what care of the family might mean in the situation Truog describes.

He assumes—without argument or support—that care for his young patient’s father meant performing “futile CPR” on a small child, and doing so in a manner that he states was so “brutal” as to make nauseous his nursing colleague.

This he claims is “treating the family.” Is it?

I ask whether one might offer care (“treating”) of families—even those who demand futile CPR or other nonbeneficial treatments—that doesn’t require futility or brutality to the patient, and that might then actually be more recognizable as care.

-- Tarris Rosell, PhD, Rosemary Flanigan Chair, Center for Practical Bioethics