Patient's Decision against CPR

00:01 So, it's important to understand all of those issues because really this comes down to an informed consent process.

00:09 So, we want to have a discussion with the patient, talk to them about their medical condition.

00:16 This is sort of in anticipation of an emergency event happening in the future.

00:20 Again, our usual presumption is that they're going to want CPR but there may be patients where in our opinion as well as, you know, our understanding of the patient's values, CPR, you know, decision not to use CPR would not be unreasonable.

00:36 We think that either the patient or their authorized decision-maker if the patient can make their own decisions really needs to be asked, do you want to consent to or refuse this proposed emergency treatment called CPR? The opportunity, you know, exists.

00:53 Therefore, you now, when the patient is able to communicate with you to initiate these discussions before you actually need to institute the CPR.

01:01 So, you want to illicit the patient's wishes about emergency treatments.

01:05 You want to know what the contingency plans would be if you decide not to institute CPR.

01:11 You know, what if they have a cardiac arrest? What are we going to do in those circumstances? The various ways to enter into this conversation with the patient, you could start with something like, what's your understanding of CPR? You know, do they know what it involves? Can you explain sort of the process of what happens in CPR? Maybe they've seen it on TV or in a movie or something.

01:35 So, you just want to get their basic understanding of what it means.

01:39 And then, you might ask, well, what's your understanding of how successful it is? And then, you can give them information, you know, in actuality, the majority of the times, CPR does not work.

01:51 It depends on, you know, all those factors that I talked about before.

01:55 But, you know, we're talking about, you know, 20%, maybe 40% at most where you're going to have a successful outcome.

02:04 And putting that in the context of then, what do you know about the patient's medical condition that might speak to their individual prognosis? That's the way to get into the conversation with them about whether they would want it or not want it.