ArticlePloS one2023
Ethical considerations in the prehospital treatment of out-of-hospital cardiac arrest: A multi-centre, qualitative study.
Article in PloS one, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
What it found
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Who cites it
7 citing papers in PubMed, 7 citations in OpenAlex.
- Incidence and epidemiology of out-of-hospital cardiac arrest in Upper Austria : A multicenter, retrospective cohort study.Wiener klinische Wochenschrift · 2026Article
- Defining Critical Emergency Medicine (CrEM): A Delphi Study From Scandinavia.Acta anaesthesiologica Scandinavica · 2026Article
- Sex differences in neurological outcomes for patients with In-Hospital cardiac arrest.BMC cardiovascular disorders · 2025Article
- Development and Validation of a Case-Based Survey Assessing Ethical Decision-Making in Prehospital Resuscitation.Healthcare (Basel, Switzerland) · 2025Article
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- Negotiating grey areas: an interview-based analysis of paramedic uncertainty and decision-making in cardiac arrest events.BMC emergency medicine · 2024Article
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPrehospital emergency physicians have to navigate complex decision-making in out-of-hospital cardiac arrest (OHCA) treatment that includes ethical considerations. This study explores Danish prehospital physicians' experiences of ethical issues influencing their decision-making during OHCA.
methodsWe conducted a multisite ethnographic study. Through convenience sampling, we included 17 individual interviews with prehospital physicians and performed 22 structured observations on the actions of the prehospital personnel during OHCAs. We collected data during more than 800 observation hours in the Danish prehospital setting between December 2019 and April 2022. Data were analysed with thematic analysis.
resultsAll physicians experienced ethical considerations that influenced their decision-making in a complex interrelated process. We identified three overarching themes in the ethical considerations: Expectations towards patient prognosis and expectations from relatives, bystanders, and colleagues involved in the cardiac arrest; the values and beliefs of the physician and values and beliefs of others involved in the cardiac arrest treatment; and dilemmas encountered in decision-making such as conflicting values.
conclusionThis extensive qualitative study provides an in-depth look at aspects of ethical considerations in decision-making in prehospital resuscitation and found aspects of ethical decision-making that could be harmful to both physicians and patients, such as difficulties in handling advance directives and potential unequal outcomes of the decision-making. The results call for multifaceted interventions on a wider societal level with a focus on advance care planning, education of patients and relatives, and interventions towards prehospital clinicians for a better understanding and awareness of ethical aspects of decision-making.
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