Pre-hospital cardiac arrest: a call for moral agency in modern medical practice.

This article features an exemplary case of a terminally ill man with a do-not-resuscitate (DNR) order who is subject to a resuscitation attempt after suffering an out-of-hospital cardiac arrest (OHCA). The case is explored for its philosophical implications in the broader perspective of medical ethics. It is argued that the metaphysics of modern medical practice seems to have shifted away from the overall purpose and meaning of medical intervention to a primary concern with immediate effects of treatment, led on by medical advances and strict adherence to standard procedures. Whether it being the attempted resuscitation of a terminally ill patient in cardiac arrest, or the overtreatment of terminally ill or dying patients in general. In this article it is concluded that the best overall pre-hospital care is not achieved by adherence to standard procedures alone but also rests on the recognition and support of emergency medical technicians (EMTs) as moral agents, capable of exercising moral judgment based on the individual patients’ situation. Our intention is not to critique the actions of individuals, nor do we make claims about frequency of occurrence. Rather, we draw attention to a general shift in focus and mode of thinking in the Danish healthcare system to discuss solutions.The study was approved by University of Southern Denmark’s Ethics Committee. Written informed consent to participate and publish was obtained from the participant. This study was supported by the Danish Air Ambulance.