Ethical Principles of Resuscitation

The goal of resuscitation is to save human lives. The resuscitation should not aim at depriving the human being of the right to die at the end of his life.

The resuscitation should ideally be conducted under the aspect of helping a thinking, feeling and life-affirming person through a cardiac arrest without permanent severe damage to body, mind and soul.

The decision to start or end a resuscitation is in the hands of the doctor who assumes this responsibility. There is no legal security for the physician who omits a resuscitation based on ethical principles and also not for the physician who interrupts a resuscitation prematurely, whereby the timeliness is not legally secured.

There is agreement among the professional associations (AHA and ERC) that resuscitation can be omitted in patients with secured incurably metastasizing carcinomas in the case of a circulatory arrest. Furthermore, in adults, the discontinuation of resuscitation after 30 minutes of unsuccessful resuscitation attempts with asystole under exhaustion of the available ACLS means or further deterioration of the condition (e.g. initial EMD later asystole) is accepted.

The value of patient testaments ect. is not legally secured in Germany. It is theoretically assumed under certain circumstances that in the concrete situation the patient could decide differently than he has written down in writing before the occurrence of this situation.

In the preclinical situation, the emergency physician is recommended to start resuscitation more frequently and to stop it later if the course of events is unclear and the patient's medical history is not known, than he would do under comparable conditions in the clinic with the possibility of consultation with other colleagues.