Send to

Choose Destination
See comment in PubMed Commons below
Intern Med J. 2013 Jan;43(1):77-83. doi: 10.1111/j.1445-5994.2012.02841.x.

Clinical model for ethical cardiopulmonary resuscitation decision-making.

Author information

Advance Care Planning Program, Northern Health and School of Population Health, The University of Melbourne, Melbourne, Victoria, Australia.



Decisions to withhold cardiopulmonary resuscitation (CPR) for future cardiac arrest continue to be problematic, with a lack of consistency in how doctors approach this decision.


To develop a clinical model that can be used in education to improve consistency in CPR decision-making.


A qualitative study, using semistructured interviews with a total of 33 senior doctors, junior doctors and nurses from two Melbourne hospitals explored how decisions to withhold CPR are made. Interviews explored: issues arising; how doctors learn to make these decisions; how they deal with disagreement and their experiences of performing CPR. The transcripts were coded and analysed thematically.


Three major themes were identified: CPR as a life-and-death decision; good and bad dying; and trust. The research also defined the two elements to a CPR decision: (i) technical and (ii) ethical.


Applying ethical principles commonly used in medicine, a model for ethical CPR decision-making has been developed that identifies four patient groups, each with a different discussion aim. This approach simplifies the complexities of the CPR decision, providing a structured way to teach CPR decision-making to doctors and thereby achieve greater consistency in the decisions made.

[Indexed for MEDLINE]
PubMed Commons home

PubMed Commons

How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Wiley
    Loading ...
    Support Center