Friday November 07, 2014

Slow Code



This week on White Coat Black Art, host Dr. Brian Goldman looks at the Slow Code: the Code Blue procedure that's all show and no go.  He examines the grey ethics of doctors going through the motions of CPR without actually trying to save a life.

In TV and movie versions of a Code, the vast majority of patients get saved.  Nothing like a Hollywood Happy Ending!  In real life, fewer than one in eight survive .  And unlike the Hollywood version -- where those patients are young and otherwise healthy, in the real world, the vast majority are near the end of life.  In this situation, a lot of doctors think that the most humane option is to let the patient die a natural death.  That's not always possible because unless you specify otherwise in advance, doctors are obliged to do CPR and run a full Code Blue. That makes health care workers very frustrated but rather than tell you or your family, sometimes doctors revert to the Slow Code.

Second-year resident Nathan Stall describe how difficult it is to perform a full code when he knows it may be doing more harm than good.  Brian visits the QEII Health Sciences Centre in Halifax and talks with front line health professionals who struggle to communicate with families whose loved ones are near the moment of death.  John Lantos, Professor of Pediatrics and a bioethicist at the University of Missouri - Kansas City School of Medicine, defends the practice of the Slow Code.