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Intensive Care Medicine
Published in: Intensive Care Medicine 6/2016

01-06-2016 | What's New in Intensive Care

Choice architecture in code status discussions with terminally ill patients and their families

Authors: George L. Anesi, Scott D. Halpern

Published in: Intensive Care Medicine | Issue 6/2016

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Excerpt

Cardiopulmonary resuscitation (CPR) was developed to reverse sudden cardiac death due to temporary or reversible insults in previously healthy patients. As with many invasive medical interventions, use spread to less and less healthy patients, to the point at which a universal default arose in most Western nations such that all patients became “full code.” Now, if a heart stops, no matter who’s heart, clinicians try to restart it with chest compressions, shocks, assisted ventilation, and powerful drugs, unless previously and explicitly instructed otherwise [1]. …
Literature
1.
2.
Larkin GL, Copes WS, Nathanson BH, Kaye W (2010) Pre-resuscitation factors associated with mortality in 49,130 cases of in-hospital cardiac arrest: a report from the National Registry for Cardiopulmonary Resuscitation. Resuscitation 81:302–311CrossRefPubMed
3.
Nabozny MJ, Steffens NM, Schwarze ML (2015) When do not resuscitate is a nonchoice choice: a teachable moment. JAMA Intern Med 175:1444–1445CrossRefPubMed
4.
Kaldjian LC, Erekson ZD, Haberle TH et al (2009) Code status discussions and goals of care among hospitalised adults. J Med Ethics 35:338–342CrossRefPubMed
5.
Blinderman CD, Krakauer EL, Solomon MZ (2012) Time to revise the approach to determining cardiopulmonary resuscitation status. JAMA 307:917–918PubMed
6.
Blumenthal-Barby JS, Krieger H (2015) Cognitive biases and heuristics in medical decision making: a critical review using a systematic search strategy. Med Decis Making 35:539–557CrossRefPubMed
7.
VanDerhei J (2010) The impact of automatic enrollment in 401(k) plans on future retirement accumulations: a simulation study based on plan design modifications of large plan sponsors. EBRI Issue Brief 341:1–23PubMed
8.
Halpern SD, Loewenstein G, Volpp KG et al (2013) Default options in advance directives influence how patients set goals for end-of-life care. Health Aff (Millwood) 32:408–417CrossRef
9.
Halpern SD, Ubel PA, Asch DA (2007) Harnessing the power of default options to improve health care. N Engl J Med 357:1340–1344CrossRefPubMed
10.
Hart JL, Harhay MO, Gabler NB, Ratcliffe SJ, Quill CM, Halpern SD (2015) Variability among US intensive care units in managing the care of patients admitted with preexisting limits on life-sustaining therapies. JAMA Intern Med 175:1019–1026CrossRefPubMedPubMedCentral
11.
Childress JF, Liverman CT eds (2006) Organ donation: opportunities for action. National Academies Press, Washington DC
12.
Kraybill A, Dember LM, Joffe S, Karlawish J, Ellenberg SS, Madden V, Halpern SD (2015) Patient and physician views about protocolized dialysis treatment in randomized trials and clinical care. AJOB Empir Bioeth 0:1–10CrossRef
13.
Sunstein CR (2016) Nudging and choice architecture: ethical considerations. Yale J Regul (in press)
14.
Halpern S (2016) Judging nudges. Am J Bioeth (in press)
Metadata
Title
Choice architecture in code status discussions with terminally ill patients and their families
Authors
George L. Anesi
Scott D. Halpern
Publication date
01-06-2016
Publisher
Springer Berlin Heidelberg
Published in
Intensive Care Medicine / Issue 6/2016
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-016-4294-7

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