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Posted on June 7, 2019 at 4:00 AM

The medical and bioethics literature frowns upon slow codes and show codes. It also generally frowns upon unilateral DNR orders.

In contrast, once clinicians begin resuscitation efforts, they almost always can stop once they judge that stopping is clinically appropriate. Confirming the legality of this clinical discretion is a recent decision from the Ontario Health Professionals Appeal and Review Board.

The patient’s wife and substitute decision maker complained to the medical board that the attending physician “did not request her permission to stop resuscitation during the patient’s cardiac arrest.” The HPARB affirmed the board’s decision to take no action given the urgency of the situation.

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