Volume 13, Issue 2 (June 2026)                   Health Spiritual Med Ethics 2026, 13(2): 107-114 | Back to browse issues page

Ethics code: IR.IAU.MSHD.REC.1403.135


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1- Department of Nursing, GKM.C, Islamic Azad University, Gonbad Kavos, Iran.
2- Department of Nursing, Astan Quds Razavi Medical Institute, Mashhad, Iran., Mashhad , yousefi.reza66@gmail.com
3- Department of Nursing, Az.C., Islamic Azad University, Azadshahr, Iran., Azad Shahr
4- Master's degree in internal surgical nursing, director of the nursing department, Islamic Azad University of Gonbad Kavos, Golestan, Iran, Gonbad Kavos
5- Department of Medical Ethics, Ma.C. Islamic Azad University, Mashhad, Iran., Mashhad
Abstract:   (662 Views)

Background and Objectives: Cardiopulmonary resuscitation (CPR) is one of the most crucial life-saving measures for medical staff facing ethical challenges. Nurses are pioneers in the field of CPR care and treatment operations. This study aimed to explain the ethical challenges faced by nurses caring for patients undergoing CPR.

Methods: This qualitative research was conducted using a phenomenological approach, with purposeful sampling and data saturation, with 12 nurses who met the criteria for participation. Data were collected using semi-structured interviews and analyzed using content analysis.

Results: The mean age of the participants was 34.91, and seven were men, and five were women. Content analysis led to the discovery of four main themes and ten subcategories: 1) religious and cultural dimensions, 2) patient and family dimensions, 3) personal and human dimensions, and 4) scientific dimensions, team therapy, and regulations.

Conclusion: The principle of not harming a patient with no hope of survival can be emphasized as an ethical principle by relevant authorities. Additionally, paying attention to nurses’ emotions and ethical conflicts can be effective in reducing burnout.

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Type of Study: Original Article | Subject: General
Received: 2025/02/10 | Accepted: 2025/10/26 | Published: 2026/01/30

References
1. Bai Z, Wang L, Yu B, Xing D, Su J, Qin H. The success rate of cardiopulmonary resuscitation and its correlated factors in patients with emergency prehospital cardiac arrest. Biotechnol Genet Eng Rev. 2024; 40(3):2720-9. [DOI:10.1080/02648725.2023.2202516] [DOI:10.1080/02648725.2023.2202516]
2. Lee MR, Cha C. Emergency department nurses' experience of performing CPR in South Korea. Int Emerg Nurs. 2018; 38:29-33. [DOI:10.1016/j.ienj.2017.09.008] [DOI:10.1016/j.ienj.2017.09.008]
3. Stapczynski J, John Ma O, Tintinalli JE, Yealy D, Cline D, Meckler GD, et al. Tintinallis emergency medicine A comprehensive study guide. 9th ed. Montreal: McGraw-Hill Education; 2019. [Link]
4. Ahn S, Jung S, Park JH, Cho H, Moon S, Lee S. Artificial intelligence for predicting shockable rhythm during cardiopulmonary resuscitation: In-hospital setting. Resuscitation. 2024; 202:110325. [DOI:10.1016/j.resuscitation.2024.110325] [DOI:10.1016/j.resuscitation.2024.110325]
5. Sharabi AF, Singh A. Cardiopulmonary arrest in adults. In: Abai B, editor. StatPearls. Treasure Island (FL): StatPearls Publishing; 2025. [PMID]
6. Almutairi NS, Alharthy NA, Almaziad AM, Alsalloum AT, AlHarbi RA, Almulhem SA, et al. Parental perceptions of the importance of pediatric out-of-hospital cardiopulmonary resuscitation for the survival rate in Saudi Arabia: a cross-sectional survey. Int J Emerg Med. 2023; 16(1):76. [DOI:10.1186/s12245-023-00564-3] [DOI:10.1186/s12245-023-00564-3]
7. Inoue A, Hifumi T, Sakamoto T, Kuroda Y. Extracorporeal cardiopulmonary resuscitation for out-of-hospital cardiac arrest in adult patients. J Am Heart Assoc. 2020; 9(7):e015291.[DOI:10.1161/jaha.119.015291] [DOI:10.1161/JAHA.119.015291]
8. Salih ZNI, Draucker CB. Facilitators of and barriers to successful teamwork during resuscitations in a neonatal intensive care unit. J Perinatol. 2019; 39(7):974-82. [doi:10.1038/s41372-019-0380-3] [DOI:10.1038/s41372-019-0380-3]
9. Tenge T, Schallenburger M, Batzler YN, Roth S, M Pembele R, Stroda A, et al. Perceptions on specialist palliative care involvement during and after cardiopulmonary resuscitation: A qualitative study. Crit Care Explor. 2024; 6(4):e1077. [DOI:10.1097/cce.0000000000001077] [DOI:10.1097/CCE.0000000000001077]
10. Koroukian SM, Douglas SL, Vu L, Fein HL, Gairola R, Warner DF, et al. Incidence of aggressive end-of-life care among older adults with metastatic cancer living in nursing homes and community settings. JAMA Netw Open. 2023; 6(2):e230394. [DOI:10.1001/jamanetworkopen.2023.0394] [DOI:10.1001/jamanetworkopen.2023.0394]
11. Perman SM, Elmer J, Maciel CB, Uzendu A, May T, Mumma BE, et al. 2023 American Heart Association focused update on adult advanced cardiovascular life support: an update to the American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2024; 149(5):e254-73. [DOI:10.1161/CIR.0000000000001194] [DOI:10.1161/CIR.0000000000001194]
12. Penagaluru PK, Sultana S. A comprehensive review of research methods in emergency medicine quality and safety. J Emerg Med Trauma Acute Care. 2025; 2025(2):19. [DOI:10.5339/jemtac.2025.19] [DOI:10.5339/jemtac.2025.19]
13. James R, Norman M, Givans R, Stephenson S, Irvine R, Blidgen J. A Case of right ventricular rupture during cardiopulmonary resuscitation. Clin Surg. 2023; 9(4):1-3. [Link]
14. Wyckoff MH, Singletary EM, Soar J, Olasveengen TM, Greif R, Liley HG, et al. 2021 International consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations: Summary from the basic life support; advanced life support; neonatal life support; education, implementation, and teams; first aid task forces; and the Covid-19 working group. Resuscitation. 2021; 169:229-311. [DOI:10.1016/j.resuscitation.2021.10.040] [DOI:10.1016/j.resuscitation.2021.10.040]
15. Sterie AC, Weber O, Jox RJ, Rubli Truchard E. "Do you want us to try to resuscitate?": Conversational practices generating patient decisions regarding cardiopulmonary resuscitation. Patient Educ Couns. 2022; 105(4):887-94. [DOI:10.1016/j.pec.2021.07.042] [DOI:10.1016/j.pec.2021.07.042]
16. Kelly PA, Baker KA, Hodges KM, Vuong EY, Lee JC, Lockwood SW. Nurses' perspectives on caring for patients with do-not-resuscitate orders. Am J Nurs. 2021; 121(1):26-36. [DOI:10.1097/01.naj.0000731652.86224.11] [DOI:10.1097/01.NAJ.0000731652.86224.11]
17. Memis HK. Do Not Resuscitate (DNR) Orders from an Islamic Perspective. Darulfunun Ilahiyat. 2022; 33(2):411-37. [DOI:10.26650/di.2022.33.1.1096891] [DOI:10.26650/di.2022.33.1.1096891]
18. Dignam C, Brown M, Thompson CH. Moving from "do not resuscitate" orders to standardized resuscitation plans and shared-decision making in hospital inpatients. Gerontol Geriatr Med. 2021; 7:23337214211003431. [DOI:10.1177/23337214211003431] [DOI:10.1177/23337214211003431]
19. Asadi-Lari M, et al. Cardiopulmonary resuscitation in patients with terminal illness: An ethical dilemma. Iran J Med Ethics Hist Med. 2015; 8(3):37‑45. [PMID]
20. Mentzelopoulos SD, Slowther AM, Fritz Z, Sandroni C, Xanthos T, Callaway C, et al. Ethical challenges in resuscitation. Intensive Care Med. 2018; 44(6):703-16. [DOI:10.1007/s00134-018-5202-0] [DOI:10.1007/s00134-018-5202-0]
21. López-López IM, Gómez-Urquiza JL, Cañadas GR, De la Fuente EI, Albendín-García L, Cañadas-De la Fuente GA. Prevalence of burnout in mental health nurses and related factors: a systematic review and meta-analysis. Int J Ment Health Nurs. 2019; 28(5):1032-41. [DOI:10.1111/inm.12606] [DOI:10.1111/inm.12606]
22. Nehme Z, Ball J, Stephenson M, Walker T, Stub D, Smith K. Effect of a resuscitation quality improvement programme on outcomes from out-of-hospital cardiac arrest. Resuscitation. 2021; 162:236-244. [DOI:10.1016/j.resuscitation.2021.03.007] [DOI:10.1016/j.resuscitation.2021.03.007]
23. Gugelmin-Almeida D, Tobase L, Polastri TF, Peres HHC, Timerman S. Do automated real-time feedback devices improve CPR quality? A systematic review of literature. Resusc Plus. 2021; 6:100108. [DOI:10.1016/j.resplu.2021.100108] [DOI:10.1016/j.resplu.2021.100108]

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