ETHICS AND LAW

Factors that influence decisions about cardiopulmonary resuscitation: the views of doctors and medical students

F Tyrer¹, M Williams¹, L Feathers², C Faull², I Baker³

¹ NIHR Research Design Service for the East Midlands, Department of Health Sciences, University of Leicester, Leicester, UK
² Leicestershire and Rutland Hospice, Groby Road, Leicester, UK
³ Ty Olwen, Morriston Hospital, Swansea, UK

Correspondence to:
^{Correspondence to} F Tyrer, NIHR Research Design Service for the East Midlands, Department of Health Sciences, University of Leicester, 22–28 Princess Road West, Leicester LE1 6TP, UK; fct2{at}le.ac.uk

Background: A number of studies have explored doctors’ views and experiences of cardiopulmonary resuscitation (CPR), but to our knowledge there has been no research to identify the information that doctors take into account when they make decisions about CPR.

Purpose of study: To investigate factors that influence decisions about CPR.

Study design: Qualitative study involving six focus groups with 17 doctors and four medical students in Leicester, UK.

Results: Doctors and medical students considered a number of factors important when making decisions about CPR—namely, the patient’s diagnosis, prognosis, age, quality of life, the opinions of doctors and other medical staff, and the wishes of patients and relevant others. The relative importance of each of these factors varied significantly and was influenced by the doctors’ own beliefs and values.

Conclusions: Doctors would benefit from greater support for their decision making in relation to resuscitation to reduce variability in clinical practice and to promote appropriate patient care. Identification of factors that influence doctors’ individual beliefs, attitudes and values towards resuscitation and improvement in the quality of patient communication may help to guide policy in this area.

Keywords: cardiopulmonary resuscitation; do not attempt resuscitation; DNAR; focus groups

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