Patient and family attitudes regarding the practice of procedures on the newly deceased

Performance of emergency lifesaving procedures is an integral part of emerg ency medicine resident training. Objective: To assess attitudes of ED patie nts regarding the practice of procedures on the newly deceased. Methods: A descriptive survey was administered to a convenience sample of ED patients and their families at two urban military Level-1 trauma centers. Subjects w ere asked about their overall opinions regarding the practice of nontherape utic procedural skills on themselves or relatives immediately after death i n the ED. Subgroup analysis included the issue of advanced permission and o pinions regarding procedures defined by the investigators as noninvasive (e .g., laryngeal mask airway) or invasive (e.g., cricothyrotomy). Data were a nalyzed descriptively and with chi-square as appropriate. For comparison of proportions, a sample size of at least 140 was chosen for an alpha of 0.05 and a beta of 0.10 to detect an effect size of 0.3. Alpha was corrected fo r multiple comparisons prior to the study. Results: Three hundred seventeen surveys were collected and 88% (n = 280) were complete. Seventy-five perce nt (n = 290) and 70% (n = 273) of the respondents agreed to after-death pro cedures on themselves or their relatives, respectively. However, only 40% ( n = 106) and 50% (n = 131) would allow such procedures without prior permis sion. Seventy-one percent (n = 189) were willing to give permission in a li ving will, while 85% (n = 238) indicated support of a wallet card format. T here was no significant difference in permission rates when contrasting ind ividual noninvasive and invasive procedures. Conclusion: Most patients are willing to have procedures performed on themselves or relatives shortly aft er death, yet the majority request that permission be obtained in advance. A living will or carried card would be acceptable for such permission.