The Slow Code Dilemma: When Life-Saving Efforts Cause Moral Distress

When medical teams pretend to do CPR but don't try their hardest to save the patient.

You're a doctor or a nurse working in an intensive care unit (ICU). A very sick patient's heart stops. You know that trying to resuscitate them would be futile - their underlying illness can't be cured, and cardiopulmonary resuscitation (CPR) is unlikely to restart their heart for more than a few minutes. But the family insists you "do everything" to try to save their loved one. What do you do?  

This difficult situation is all too common in ICUs across America. A recent study surveyed doctors, nurses and other providers at two hospitals in Chicago about their experiences with "slow codes" when medical teams pretend to do CPR but don't try their hardest to save the patient.  

The results show slow codes are surprisingly widespread: 69% of participants had cared for a patient who received a slow code, with an average of more than one per provider over the past year. That's despite opinions on whether slow codes are ethical. Only about half think they're acceptable if CPR is futile; the …