Equal cardiac arrest care - a qualitative study of healthcare professionals' experiences.

backgroundDiscrimination and inequities in healthcare have gained increased attention worldwide. Although many healthcare systems strive to provide equal care, evidence indicates that treatment can be influenced by patient characteristics such as gender, age, race/ethnicity, and socioeconomic status. In particular, research exploring healthcare professionals’ perceptions on equality in acute, life-threatening conditions remains limited. This study aimed to describe Swedish healthcare professionals’ perceptions of unequal and equal care when treating patients with cardiac arrest.

methodsThe study adopted a qualitative inductive design, using semi-structured interviews with 12 physicians and nurses who work in acute care clinics in Sweden. Data were analysed using thematic analysis.

resultsThe overarching theme, “Equal care under pressure—guided by principles, shaped by context”, captured how professionals perceive the provision of cardiopulonary resuscitation (CPR) during sudden cardiac arrest as fundamentally equal. CPR was described as an automatic, protocol-driven intervention offered to all patients, reinforcing the principle of equality and without any clear discrimination based on ethnicity, gender, or socioeconomic background. However, equality in practice was nuanced. Decision-making about CPR introduce ethical complexity, particularly for older patients from whom prognostic uncertainty and emotional factors could influence care. Team competence was critical for maintaining equity under pressure, while contextual factors such as location, cultural norms, and safety concerns could delay or complicate treatment. Finally, professionals emphasize the need for structured reflection, recognizing its role in learning and ethical decision-making. Together, these findings illustrate that while CPR was guided by principles of equal care, its delivery was shaped by clinical judgment, team dynamics, and situational realities.

conclusionsHealthcare professionals perceive cardiac arrest care as predominantly equal. However, subtle vulnerabilities challenge this perception. Older age emerged as the most influential factor in CPR decisions, raising concerns about potential ageism and the need for clearer Do Not Attempt Resuscitation (DNAR) criteria and patient involvement. Promoting equality requires team competence, structured reflection, and proactive communication about resuscitation preferences. Further research should examine age, multimorbidity, psychiatric illness, DNAR practices, and gender differences to strengthen equity in cardiac arrest care.