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resuscitation is paternalistic and outdated.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