Running head: WITNESSED RESUSCITATION

Family Comes First

Arnulfo Velasquez
California State University, Stanislaus 12/4/2013

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2
Family Comes First

A child has just been admitted into the emergency department and is in need of
resuscitation. Should the distraught parents of this child be allowed to be present to witness the
attempt to save his life? There is a continuing huge debate whether the parents and family should
be allowed to be present during a resuscitation attempt. The controversial topic get more specific
when looking at the nurses role is this whole situation. There are plenty of people who have
shared their opinion on this topic, but the article "Relatives in the Resuscitation Room: a Review
of Benefits and Risks" written by a staff nurse who works in a pediatric intensive care unit by
the name of Louise Clift does a great job showing why family should always be allowed to be
with their loved ones in their dying moments. There are plenty of people who have shared their
opinion on this topic. Since nurses are the care givers of patients and spend most time with
them, they should be able to allow them autonomy and let their family be present for any
emergency resuscitation if that is what they desire. Immanuel Kant's concept of duty would be
the approach for a nurse to take in helping the patient fulfill their autonomy.
In this article Louise Clift gives the risks and benefits of having loved ones present
during resuscitation of a patient. Although the author states both the risks and benefits of this
issue it is very evident that the author is more on the side of allowing loved ones to be present
during the attempts of resuscitation. She makes very strong points for allowing family to be
present while taking the perspective of the family, patient, staff/nurses, and even legal issues. She
also used a case study to show the benefits of allowing the family with their loved one in what
could be the patient's final moments.

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The author did not leave any holes in her argument while she looked at this issue from
every perspective possible. To start off Louise Clift mentions that for a parent being there while
the attempt to resuscitate is happening it gives them a sense of control, which helps a lot in the
grieving process if the patient does not make it. Another point she made was that although there
was no literature on it, loved ones believed that the patient would receive a longer attempt to
resuscitate if they were present. The author did mention that there had been research showing
that staff had concerns the family presence would influence when to stop the resuscitation. Last
thing she showed on the family perspective was that a study expressed that 94 percent of family
member who had witnessed a resuscitation would do it again. One of the biggest points the
author made on the perspective of the patient was that there is evidence that shows a patient has a
higher will to live if there is a loved one in the room during the resuscitation. Along with that the
author also makes a claim that a sick child's parental presence is so big it is not even measurable.
A point Clift made on the medical staff perspective was that most studies show that they are in
support of having family present during the resuscitation. The author also pointed out that nurses
were even more positive about witnessed resuscitation than the rest of the medical staff. On the
legal side of things the author mentioned that with the family being in the room while trying to
save the patient's life they will see that the medical team did everything possible to save the
patient's life. Them seeing the whole process would decrease the chance of any litigations. In the
result of the case study the nurse involved mentioned that after the experience of having a parent
in the resuscitation room while she was doing her job trying to keep the patient alive she now
considers it natural for a parent to be with their child if they wish. The author of the article really
covered every angle of this story, and very it is extremely clear that she sides with the patients

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and family members that wish to be allowed with each other in their last few moments of their
precious life. (Clift, pg. 15-17)
It is well known around the world that nurses take care of the patients, but something that
people might not think about is that nurses are also in charge of aiding the family. These are
some of the duties of a nurse, and Kant would agree that a nurse who fulfils their duty is a
quality nurse. A nurse is takes an oath that bounds them under a duty of care to always act in the
best interest of their patients. The author of the article makes a point that having the parent of the
dying patient in the room could increase the will to live in the time of resuscitation (Clift, pg. 1517). If their patient wants his loved ones present then the nurse should fulfill his/her duty and
allow the family members to be present during the resuscitation process. This would also give
the patient a sense of autonomy, which is another concept Kant was an advocate of. Another
point made by Clift is that the parents of the of the patient may believe that their child might
receive better care or that resuscitation will continue longer if they are present. If this is even
minimally true it still is in the best interest of the patient, so the nurse should be obligated by her
duty of a nurse to let the parents be there for the resuscitation. Kant would applaud the nurse if
he/she was fulfilling his/her duty and providing autonomy to the patient. These are some
examples of how Kant would agree with the Louise Clift, but there certainly are a number of
theorist that would not look at this issue the same way. (Kant, p. 61-62)
Along with the pros of having a family member present to witness the resuscitation,
Louise Clift gave some pretty strong cons. The cons to this issue seem to fall in line with egoism.
The author mentions that nurses believe a room is too crowded when extra people are in there.

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Another thing she mentioned was that it is a more stressful environment if the family is in there,
so an egoist would say that the nurse should not allow them in the room because is causes them
to work less effectively (Clift, pg. 15-17) . The author also pointed out that if a loved one of the
patient is in the room the nurse assumes care for them, so a nurse has to stay with them at all
times because they are liable if anything happens to them. This would also be another reason a
nurse would not want to go through that hassle when it is not necessary. An egoist would also say
that the nurse should not allow anyone because it affects them in a negative way (Clift, pg. 1517) This is just a counter argument to what Kant and the author would be for, but there is other
views beside these two that could be taken. (Clift, pg. 15-17)
A utilitarian consequentialist like Jeremy Bentham would have a completely different
outlook on how nurses should handle this situation. His idea would be to only let family come in
the room for resuscitation if there was going to be a good outcome. This would go against Kant's
theory of everything being universal. If the patient did not make it the family would feel
tremendous pain and would have been the wrong thing to do since it does not bring pleasure. The
medical staff and the nurse would also have a some grief from losing a patient, which would also
not bring any pleasure to any party involved. Bentham would want only allow the family in if the
doctor or nurse knew it was a higher chance of not losing the patient. This situation eliminates
any autonomy the patient may have thought they had and it also give the medical staff a
paternalistic power over the situation. There will always be a debate to which point of view is the
correct one. (Bentham, p. 56)
Of the positions mentioned, Kant's point of view is more effective than Bentham's
outlook for this particular situation. Kant's theory of all right things are done universally fits best
due to always giving the patient what they desire. This promotes autonomy and it is the nurses

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duty to be to do what is in the best interest of the patient (Kant, p. 61-62). If a parent who was a
doctor or a nurse had a child being resuscitated they should be there to make sure everything
possible is being done. If these parents have that right then every parent should have a right to
see their child's last moments and to make sure everything was done in the attempt of saving the
patient's life. Bentham would only allow the family into the room if the doctors thought it was a
good chance that the patient would survive. This would leave all decisions to the doctors and
nurses and leave no autonomy for the patient. Letting every parent spend the last intimate
moments with their child would promote the preservation of wholeness, dignity and integrity of
the family unit, from birth to death. Kant's view would provide the last moments of a parent
having their child no matter the circumstances. (Clift, pg. 15-17)
Witnessed resuscitation seems to be a topic that will never have unanimous take on it.
This issue has the similar controversy to the issues of aid-in-dying and abortion. There will
always be theorists and law makers that are going to have their perspectives on whether hospitals
should allow family members in the room while an attempt of resuscitation is taking place.
Louise Clift did an excellent job on her article of covering all perspectives on the issue. The
theorist that to this day has the best perspective is by far Immanuel Kant. His concepts of
fulfilling one's duty in life and giving people autonomy are a perfect fit for this issue of
witnessed resuscitation. Resuscitation of a loved one is something anybody can go through. Now
the question is, will they the loved one be a witness to it and spend the last moments with their
loved one?

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Reference
Jeremy Bentham. "Normative Theories of Ethics." Course reading pack
Immanuel Kant. "Normative Theories of Ethics." Course reading pack

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Egoism. "Normative Theories of Ethics." Course reading packet
Louise Clift. "Relatives in the resuscitation room:a review of benefits and risks". pediatric
nursing June volume 18 no. 5