Bioethics Blogs

Don’t Categorically Refuse CPR to Ebola Patients

Recently it has been argued that cardiopulmonary resuscitation (CPR) should, as a matter of policy, not be offered to persons with Ebola disease. Such a categorical restriction of CPR based solely on a patient’s diagnosis rather than his prognosis would be unique in modern medical practice. Beyond this, the general public’s concerns about Ebola, marked by fear and manifested by the social exclusion of recovered patients and their families, makes it especially important to avoid even unintentional suggestions that Ebola is not like any other life-threatening illness.

While the overall survival rates for persons requiring in-hospital CPR are low, specific patients may benefit from CPR, and categorically restricting use of this procedure could further contribute to the social devaluation of Ebola patients. However, staff who courageously accept the responsibility of caring for them are entitled to every effort we can make to secure their safety from the contagion. 

Several commentators have proposed that, while a range of intensive interventions may be appropriate in caring for patients with Ebola, “the line should be drawn at CPR.”  Some institutions are said to be considering similar limitations. (See Reuters and the Wall Street Journal .) The arguments of those opposed to offering CPR have rested on several presumptions: the concern that resuscitation would be counterproductive (nonmaleficence), the claim that persons with Ebola who experience cardiorespiratory arrest cannot be saved (futility), that the requirements for adequate personal protective gowning would delay resuscitative efforts unacceptably, and the fear that CPR would expose hospital staff to unacceptably high risks for infection.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.