Evidence map›Paper›PMID 42177508›Full record

ArticleBMC medical ethics2026

The ethical and clinical conflict of cardiopulmonary resuscitation (CPR) in the emergency department: futile interventions.

Hasan Sultanoğlu, Arif Hüdai Köken, İbrahim Topçu, Hamza Tahir Hallaç

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Article in BMC medical ethics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

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0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Hasan SultanoğluDepartment of Emergency Medicine, School of Medicine, Düzce University, Düzce, Türkiye. drsultanoglu@hotmail.com.
Arif Hüdai KökenDepartment of History of Medicine and Ethics, School of Medicine, Kırşehir Ahi Evran University, Kırşehir, Türkiye.
İbrahim TopçuDepartment of History of Medicine and Ethics, Hamidiya Medical Faculty, University of Health Sciences, İstanbul, Türkiye.
Hamza Tahir HallaçDepartment of Emergency Medicine, School of Medicine, Düzce University, Düzce, Türkiye.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveScientific and technological advancements have significantly contributed to increased life expectancy; however, unresolved debates persist regarding quality of life and the dying process. Cardiopulmonary resuscitation (CPR) performed on terminal patients in the emergency department remains a subject of clinical and ethical controversy. This study aims to evaluate the ethical conflicts faced by physicians when making decisions about potentially futile treatments in emergency settings. MATERIALS AND

methodsThis study was conducted in the emergency department of a university hospital in Türkiye and consisted of two phases. In the first phase, 118 cardiac arrest cases were analyzed among 446,397 patients who presented to the emergency department between 2020 and 2025. In the second phase, emergency physicians were surveyed regarding their decisions to initiate or terminate CPR.

resultsAccording to the findings, the average age of patients who responded to CPR was 65.54 ± 13.49, whereas non-responders were significantly older. Although the majority of physicians believed that discontinuing CPR is ethically inappropriate, 98% were able to accurately predict cases in which CPR would be futile. Among physicians who refrained from terminating CPR despite anticipating non-responsiveness, the most frequently cited reasons included "concerns over legal, ethical, and professional responsibilities" (79.3%), followed by "social pressure (risk of violence or complaints)" (75.9%), and "noncompliance with religious and cultural beliefs" (69%, n = 20).

conclusionPhysicians' reluctance to terminate futile treatment is influenced by legal and ethical responsibilities, social pressures, religious beliefs, and empathy. The study highlights the ethical and clinical conflicts faced by physicians in decisions regarding futile CPR and emphasizes the need for multidisciplinary approaches and ethical guidelines in such cases. Additionally, providing family members with clear information about the likely outcomes of CPR may facilitate ethical decision-making.

Indexed as

Cardiopulmonary ResuscitationClinical Decision-MakingEmergency Service, HospitalEthical DilemmasPhysiciansAdultAgedAttitude of Health PersonnelFemaleHeart ArrestHumansMaleMiddle AgedTurkeyWithholding TreatmentCardiopulmonary resuscitationEmergency serviceEthical dilemmasHospitalMedical futilityWithholding treatment

Identifiers

PMID42177508
PMCPMC13383533

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LicenceCC BY-NC-ND
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.