To resuscitate or not resuscitate

Even though most of the patients opted for the fictional patients to forego the resuscitation, it wasn’t clear whether the fictional patients had come to such a decision on their own or were advised by their doctors to skip the cardiopulmonary resuscitation. However, the study also showed that patients who participated did not think less of doctors who advise patients to forgo the life- saving efforts in case a cardiac arrest occurs.

The reassurance that either of these approaches offers is that both patient and doctor guided decisions of being resuscitated have a high likelihood of reaching similar results, noted Dr. Eduardo Bruera, an author working University of Texas MD Anderson Cancer Center. It is possible for cancer patients who are dying to survive a cardiac arrest when CPR is given. However, experts also note that most of the patients who survive the event later suffer from more serious complications and they end up dying within days or weeks.

Effectiveness of videos in making resuscitation decisions

An alternative to this is for the patient to advise his doctor not to resuscitate him in times of a crisis. But it was also noted that cancer patients rarely have any kind of conversation with their physicians on the issue of doing a CPR during an emergency. Together with his colleagues, Bruera aimed at testing approaches to this kind of conversations and check whether cancer patients should be advised on the best thing to do or just left on their own to make the decisions alone after knowing about the information.

The study was undertaken on 78 patients suffering from advanced cancer at the MD Anderson where they watched the two videos that showed a doctor telling her patient woman with cancer about the various resuscitation options. One of the videos showed the doctor advising the patient to opt for no resuscitation option while in an almost similar video; the physician asked the patient whether she wished to opt out the option of CPR. All the 30 patients in the study who had opted not to be resuscitated themselves elected the same option for the video patient. Of the 48 cancer patients who were yet to make any CPR decision, 30 of them chose the same option for the video option.

Factors like socioeconomic status, gender and age were not associated to the patient’s not resuscitate option and only three patients had discussed resuscitation options with the doctor. If a conversation occurs, Bruera said that patients can make the decision on their own only that they hadn’t discussed about it with their doctors.

Using video technology in hospitals rather than having a simple conversation is much more effective way of ensuring that patients access the information they need in order to make a decision. The potential for the video to be effective is that it is used as an education tool first after which more personalized conversation about the matter is introduced.