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Resuscitation 'slow codes' should go

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The practice of using ‘slow codes’ to resuscitate hopelessly ill patients is undignified and can prolong suffering, an article in the Journal of Clinical Nursing has warned.

The paper calls for legal guidelines to prevent the use of slow codes, a practice whereby healthcare professional resuscitate a patient too slowly for their efforts to be successful.

The papers author Jacinta Kelly, nursing ethics lecturer at Trinity College Dublin, said: ‘If a DNAR order does not exist, healthcare professionals are expected to attempt resuscitation even if the patient is terminally ill. Slow codes are seen as a way of going through the motions, being kinder to desperately ill patients and avoiding potential legal action.’

However, she said her review of international research veiled conflicting views over its use. ‘While some researchers argue that it is kinder to use slow codes when a patient is devastatingly ill, others maintain that it is harmful and deceptive,’ she said.

She called for further research into why slow codes are used and how nurses and doctors decide when to carry out token resuscitation attempts.

Journal of Clinical Nursing (2007) 16: 1989-1998

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