Ethics of resuscitation

The length of life is not always equal to its quality. When thinking about reviving a severely chronically ill patient, it is appropriate to ask whether life after resuscitation will be sufficiently valuable for him. It is important that the patient can answer this question himself. This is possible thanks to a joint conversation about treatment goals and advance health care planning. This algorithm guides you through the entire process from the diagnosis of a serious chronic patient condition to the moment of his death.

share-decision making
advance care planning
ethics of resuscitation
living will
Published at: 19.7.2022


Mahulena Exnerová, MD
Chief Physician, Children`s Department, Hořovice hospital, Czech Republic External Pediatrican, Mobile Hospice Cesta domů

I thank the authors for the work done and the preparation of the algorithm, which deals with the sensitive but extremely important topic of communication with a patient who has a serious chronic disease with an uncertain prognosis of life expectancy, in whom we expect his further progression in the coming weeks and months. The process of communicating serious messages has its own rules and there are various protocols that can facilitate such communication. However, I consider it essential in this context that every doctor who takes care of such patients should have basic knowledge in the field of general palliative care. Such knowledge certainly includes communication skills and awareness of who I can turn to as a specialist in difficult situations, and to whom the patient and his family can turn. The developed algorithm is clear and at individual points it presents in a simplified manner important steps in the process of communicating a serious diagnosis, joint communication of care goals and advance care planning, including the possibility of writing down a living will and the correct procedure in the event of the existence of such a document. In addition to good communication with the patient, the algorithm also includes the subsequent support of family members. I can imagine different scenarios for this story, and it's not realistic to include all possibilities in the tutorial algorithm. The authors still managed to describe all the important points in the process of sensitive communication with a patient who has a progressive serious chronic disease without the possibility of curative treatment. Such a procedure significantly increases the probability that we will be able to meet the jointly set goals of care with respect for the values ​​and preferences of the specific patient and his loved ones, which should always be our priority.


MENTZELOPOULOS, Spyros. COUPER, Keith. VAN DE VOORDE, Patrick. DRUWE, Patrick. BLOM, Marieke. PERKINS, Gavin. LULIC, Ileana, DJAKOW, Jana. RAFFAY, Violetta. LILJA, Gisela. BOSSAERT, Leo. European Resuscitation Council Guidelines 2021: Ethics of resuscitation and end of life decisions. RESUSCITATION. CLARE: ELSEVIER IRELAND LTD, 2021, roč. 161, April 2021, s. 408-432. ISSN 0300-9572. doi:10.1016/j.resuscitation.2021.02.017.

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