Do Patients Want Family Members Present During Resuscitation?

Several studies have shown that family members would like to be present during the resuscitation of loved ones, particularly of children. The authors of this study assessed patient preferences about this practice. They surveyed a convenience sample of 266 adults present in the waiting room of an urban emergency department. Severely ill patients were excluded.

Participants were presented with one scenario describing procedures that might be used during resuscitation (cardiopulmonary resuscitation; insertion of IV lines; placement of urinary catheters and breathing tubes; minor surgery; defibrillation) and were asked whether they would want to have family members present if they were seriously sick or injured and required those procedures. Of 200 respondents, 72% would want a family member to be present, and 21% would not. Of the positive responders, 56% would want only certain family members to be present (spouse, 54%; parents, 43%; children, 31%; siblings, 22%; other, 22%). Negative responders tended to be older and were more likely to be white than positive responders.

Comment: Recently, some authors have suggested that the practice of not allowing family members to be present during resuscitation is paternalistic and outdated. Proponents of the practice of allowing family members to be present cite benefits in the grieving process. But the authors of the current study throw a curve ball: Patients may not want family members present during resuscitation. The potential conflict between wishes of dying patients and those of family members poses a quandary in the emergency department setting, where patients may not have made their preferences known to their family or physicians. Like everything in medicine, physicians will need to address these concerns case by case.

— Diane M. Birnbaumer, MD, FACEP

Published in Journal Watch Emergency Medicine August 25, 2004