Bioethics for Breakfast: Partial Codes: Is Something Better than Nothing?

bioethics-for-breakfastTom Tomlinson, PhD, and Courtenay Beattie, BSN, RN, presented at last Thursday morning’s Bioethics for Breakfast event, offering opposing views on the topic, “Partial Codes: Is Something Better than Nothing?”

Normally, when someone in the hospital stops breathing or has a cardiac arrest, the team that responds runs a “full code,” following a protocol that maximizes the chance of getting the patient’s heart and lungs working again and saving the patient’s life – at least for the moment. When a patient or a patient’s family doesn’t want this attempt to be made, perhaps because the patient is near death from a terminal illness, the physician will order a “no code” or a do-not-resuscitate order. But, sometimes the attending physician will instead order a “partial code,” meaning only some part of the normal full code protocol is withheld. Chest compressions to try to get the heart beating again may be attempted but without any attempt to open the airway or put the patient on a ventilator to restore respiration. These partial codes are the subject of ongoing medical and ethical controversy. Some hospitals allow them, even providing “menus” of resuscitative interventions from which patients or families can select. Other hospitals prohibit them completely.

In the discussion, speakers and attendees explored this debate and tried to decide: when it comes to resuscitation, is something always better than nothing?

Tom Tomlinson, Ph.D.
Tom Tomlinson is Director of the Center for Ethics and Humanities in the Life Sciences and Professor in the Department of Philosophy, Michigan State University.

Courtenay Beattie, BSN, RN
Courtenay Beattie is Nurse Manager for the Cardiac Intensive Care Unit at Sparrow Hospital and a graduate of Michigan State University.

About Bioethics for Breakfast:

In 2010, Hall, Render, Killian, Heath & Lyman invited the Center for Ethics to partner on a bioethics seminar series. The Center for Ethics and Hall Render invite guests from the health professions, religious and community organizations, political circles, and the academy to engage in lively discussions of topics spanning the worlds of bioethics, health law, business, and policy. For each event, the Center selects from a wide range of controversial issues and provides two presenters either from our own faculty or invited guests, who offer distinctive, and sometimes clashing, perspectives. Those brief presentations are followed by a moderated open discussion.