Deresuscitate

Deresuscitate is a verb describing the act of reversing or stopping resuscitation efforts, typically CPR, when a patient is in cardiac arrest or respiratory failure. In common medical language, this action is more often described as withdrawing resuscitation or withholding resuscitation. The term is relatively rare and not widely used in formal guidelines.

Etymology and usage: The word derives from de- meaning reversal and resuscitate. It appears mainly in ethical discussions, case reports, or informal speech, rather than in official protocols. More precise terms include withdrawal of resuscitation, withholding resuscitation, or not performing CPR under a Do Not Resuscitate (DNR) order.

Clinical context: In emergency or hospital settings, a decision to deresuscitate arises when ongoing CPR is considered futile, when it conflicts with patient wishes expressed via advance directives or surrogates, or when prognosis is hopeless. The decision typically leads to implementing a DNAR or WLST order, allowing the team to stop resuscitation and shift to palliative care as appropriate.

Ethical and legal considerations: Deresuscitation involves patient autonomy, beneficence, and justice, and is governed by local laws and hospital policies. Practitioners must document the decision, communicate with family or surrogates, and ensure that stopping resuscitation aligns with the patient's values and best interests. Standards vary by jurisdiction, with some places emphasizing explicit DNAR orders, while others permit withholding resuscitation without a formal order in certain circumstances.

Terminology and alternatives: Because deresuscitate can be ambiguous, many clinicians prefer phrases such as "withdrawal of resuscitation," "withholding resuscitation," or "do not resuscitate" to convey the intention clearly. In education and guidelines, the emphasis is on respecting the patient's goals and ensuring that life-sustaining interventions are aligned with those goals, rather than on the act of stopping resuscitation itself.