”—reflected a deep concern that patient autonomy was being eroded by medical paternalism.
The issue wasn’t just CPR’s lack of effectiveness; the pandemic revealed the deeper, trickier problem of what it symbolized. The bioethicist Nancy Jecker has written that “reflexively using CPR” suggests a fear of failure, of “.” Over the years, patients and families have told me that CPR represents a human right, a decision to go down fighting, a show of advocacy for their loved one, and a sign that everything possible has been tried. For doctors, too, it’s a ritual, a talisman of care.
I know now that these conversations are procedures, demanding the same precision of everything else in medicine. Doctors must learn to say what is true. “I hope that everything we are doing for Ernesto will help him to go home eventually,” I said. “But I also want to talk about a Plan B, just in case.” Even if a person is on a ventilator, I continued, sometimes their lungs can get so sick that their heart can’t get enough oxygen. “When that happens, the heart can stop, which means they have died. At that point, sometimes we start a procedure called CPR.