Family Witnessed Resusitation
Discuss the legal and ethical issues regarding family-witnessed resuscitation (FWR)
There are several legal and ethical issues relating to FWR. Some of the key legal concerns expressed by healthcare professionals include the potential for litigation, patient confidentiality, and the patient’s right to privacy (Mian et al, 2007; Critchell et al, 2007). Litigation and liability concerns arise from the fact that, in most cases, family members will have little understanding of the procedures used in the code room. The fear is that the staff’s actions could be perceived as detrimental or harmful to the patient in the eyes of the typical lay-person. The reality is that once healthcare providers become educated and experienced with FWR, this fear is alleviated, as found in a study conducted by Mian et al (2007). In this same study however, confidentiality and privacy concerns were unchanged, suggesting that this is an issue hospitals will need to address if they are to implement FWR.
The ethical issues involved with FWR revolve around the mental and emotional impact that families and medical professionals may experience if a code is witnessed. Performance anxiety and the potential loss of professional distance from the patient for healthcare providers and how traumatic the experience may be for family members are major ethical concerns with FWR (Mian et al, 2007; Critchell et al, 2007). Mian et al found that nurse attitudes regarding potential trauma for the family improved with experience while physician attitudes did not. Studies of family member reactions suggest that the experience is not excessively traumatic for family and may actually be a beneficial part of the grieving process (Critchell et al, 2007). Performance anxiety for the staff seems to be the bigger issue. Though this factor seems to improve with experience (Mian et al, 2007), staff anxiety will still be a driving concern when it comes to the ethical consideration of whether or not it is
There are several legal and ethical issues relating to FWR. Some of the key legal concerns expressed by healthcare professionals include the potential for litigation, patient confidentiality, and the patient’s right to privacy (Mian et al, 2007; Critchell et al, 2007). Litigation and liability concerns arise from the fact that, in most cases, family members will have little understanding of the procedures used in the code room. The fear is that the staff’s actions could be perceived as detrimental or harmful to the patient in the eyes of the typical lay-person. The reality is that once healthcare providers become educated and experienced with FWR, this fear is alleviated, as found in a study conducted by Mian et al (2007). In this same study however, confidentiality and privacy concerns were unchanged, suggesting that this is an issue hospitals will need to address if they are to implement FWR.
The ethical issues involved with FWR revolve around the mental and emotional impact that families and medical professionals may experience if a code is witnessed. Performance anxiety and the potential loss of professional distance from the patient for healthcare providers and how traumatic the experience may be for family members are major ethical concerns with FWR (Mian et al, 2007; Critchell et al, 2007). Mian et al found that nurse attitudes regarding potential trauma for the family improved with experience while physician attitudes did not. Studies of family member reactions suggest that the experience is not excessively traumatic for family and may actually be a beneficial part of the grieving process (Critchell et al, 2007). Performance anxiety for the staff seems to be the bigger issue. Though this factor seems to improve with experience (Mian et al, 2007), staff anxiety will still be a driving concern when it comes to the ethical consideration of whether or not it is
References: Crtichell, C. D., & Marik, P. E. (2007). Should Family Members Be Present During Cardiopulmonary Resuscitation? A Review of the Literature. American Journal of Hospice , 24, 311-316. Mian, P., Warchal, S., Whitney, S., Fitzmaurice, J., & Tancredi, D. (2007). Impact of a Multifaceted Intervention on Nurses’ and Physicians’ Attitudes and Behaviors Toward Family Presence During Resuscitation. Critical Care Nurse, 27, 52-60.