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became the first state in the United States to effectively end the practice by enacting legislation to require medical staff to honour a patient's refusal of cardiopulmonary resuscitation or a do not resuscitate order, and to grant civil and criminal immunity to those who do so or those who perform
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and its accompanying severe opportunistic illnesses (which are not responding to antiretroviral and drug therapy and/or the white blood cell count is too low), or those who are older than about 70 and/or homebound (where they and/or their guardians, instead of a DNR order, have authorized such half
75:
privileges over the patient, or other surrogate decision maker for the patient, makes such a request of the medical staff. Surrogate decision makers are considered in a hierarchy: legal guardians with health care authority, individual with power of attorney for health decisions, spouse, adult
481:
Dosha, Kristofer; Dhoblea, Abhijeet; Evonicha, Rudolph; Guptaa, Amit; Shaha, Ibrahim; Gardiner, Joseph; Dwamenaa, Francesca C. (September 2009). "Analysis of limited resuscitations in patients suffering in-hospital cardiac arrest".
60:. A medical response team, based on the institution's practices and policies, attends to the emergency. The team will perform life saving measures, including CPR, in order to re-establish both cardiac and pulmonary function.
99:
which is no longer treatable with assisted ventilation methods and medication, which all have very little or no realistic probability of success. There is also a low probability of success for patients with severe
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and such resuscitation "commonly violates the ethical obligation of nonmalfeasance". It is regarded as medically unsound because partial interventions are "often highly traumatic and consistently inefficacious".
45:
refers to the practice of a medical response that is medically futile, but is attempted for the benefit of the patient's family and loved ones. However, the terms are often used interchangeably.
112:(where dialysis and other renal replacement therapies either are no longer working or were not adequate, and where a transplant either cannot be found or is not an option), end-stage
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The practice is "controversial from an ethical point of view", as it represents a violation of a patient's trust and right "to be involved in inpatient clinical decisions".
79:
A third situation is one in which the medical staff deems that CPR will be of no clinical benefit to the patient. This includes, among other cases: a patient in severe
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that resulted from shock or severe illness or injury, and has not responded to treatment (and which was not induced), severe cases of acute or chronic
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that has irreversibly damaged vital brain functions needed for life beyond repair (i.e., in the brain stem), or who has advanced and incurable
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During a patient cardiac arrest in a hospital or other medical facility, staff may be notified via a
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407:
Berger, Jeffrey T. (October 2003). "Ethical
Challenges of Partial Do-Not-Resuscitate (DNR) Orders".
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Cardiopulmonary resuscitation may be withheld in some circumstances. One is if the patient has a
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A patient may request, in an advance directive, to prohibit certain responses, including
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whose organ damage cannot be contained and reversed any longer, one who has had an acute
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DePalma, Judith A.; Miller, Scott; Ozanich, Evelyn; Yancich, Lynne M. (November 1999).
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41:(CPR) is thought to be of no medical benefit by the medical staff. The related term
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or other medical centre to purposely respond slowly or incompletely to a patient in
531:"Nursing Care and Do Not Resuscitate (DNR) and Allow Natural Death (AND) Decisions"
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Some medical services centres have instituted policy banning the practice.
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This article is about the medical practice. For the programming term, see
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438:""Slow" Code: Perspectives of a Physician and Critical Care Nurse"
263:, What if the patient is unable to say what his/her wishes are?.
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71:. Another is if the patient, family member, individual with
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302:
513:""Code Blue", "Code Black": What Does "Code" Mean?"
356:, What if the family disagrees with the DNR order?.
276:College of Physicians and Surgeons of Ontario 2006
48:The practices are banned in some jurisdictions.
197:
600:"Hospitals' 'code blue' most deadly at night"
571:College of Physicians and Surgeons of Ontario
8:
330:ANA Center for Ethics and Human Rights 2012
536:. ANA Center for Ethics and Human Rights.
160:states that "slow codes are not ethical".
16:Deliberately delayed resuscitation attempt
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76:children, parents, and adult siblings.
37:, particularly in situations for which
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567:"Decision-making for the End of Life"
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7:
511:Marks, William J. (1 January 2006).
176:CPR without knowledge of the order.
496:10.1016/j.resuscitation.2009.05.011
236:, When should CPR be administered?.
85:multiple organ dysfunction syndrome
633:"Slow Codes, Show Codes and Death"
616:. 19 February 2008. Archived from
117:measures and the law permits it).
14:
458:10.1097/00002727-199911000-00014
124:, chest compression, electrical
67:("no code") order, such as in a
450:Lippincott Williams and Wilkins
442:Critical Care Nursing Quarterly
569:. Physician Advisory Service.
383:Braddock, Clarence H. (1998).
293:, When is CPR not of benefit?.
1:
409:Archives of Internal Medicine
39:cardiopulmonary resuscitation
421:10.1001/archinte.163.19.2270
248:, When can CPR be withheld?.
29:refers to the practice in a
538:American Nurses Association
385:"Do Not Resuscitate Orders"
368:, What about "slow codes"?.
158:American Nurses Association
132:. This is referred to as a
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18:
393:University of Washington
110:end stage kidney disease
590:: CS1 maint: others (
557:: CS1 maint: others (
164:Policy and legislation
95:, and one with severe
21:algorithmic efficiency
138:partial resuscitation
342:DePalma et al. 1999
198:New York Times 1987
395:School of Medicine
389:Ethics in Medicine
65:do not resuscitate
415:(19): 2270–2275.
303:Dosha et al. 2009
93:metastatic cancer
73:power of attorney
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641:. 22 August 1987
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620:on March 5, 2016
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540:. 12 March 2012
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490:(9): 985–989.
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35:cardiac arrest
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643:. Retrieved
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618:the original
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134:partial code
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81:septic shock
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315:Berger 2003
102:hypotension
69:living will
645:2013-04-06
624:2013-04-06
577:2013-04-06
573:. May 2006
544:2013-04-06
522:2013-04-06
399:2013-04-06
376:References
210:Marks 2006
122:intubation
52:Background
466:1550-5111
452:: 89–99.
171:In 1987,
97:pneumonia
43:show code
27:Slow code
658:Category
605:NBC News
586:cite web
553:cite web
504:19581039
474:10646457
429:14581244
173:New York
31:hospital
610:Chicago
83:and/or
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156:, the
145:Ethics
89:stroke
534:(PDF)
517:WebMD
448:(3).
180:Notes
152:In a
128:, or
592:link
559:link
500:PMID
470:PMID
462:ISSN
425:PMID
130:ACLS
114:AIDS
492:doi
454:doi
417:doi
413:163
136:or
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