Rethinking Slow Codes: Gina Piscitello, Parker Crutchfield, Jason Wasserman
episode
GeriPal - A Geriatrics and Palliative Medicine Podcast
49 min
3 speakers
8 chapters
transcribed 10 hours ago
Transcript
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Transcript generated automatically by AI and may contain errors.
What are slow codes and how are they defined in clinical practice?
This episode of the Jerry Pal podcast is sponsored by the UCSF Division of Palliative Medicine, an amazing group of palliative care clinicians doing amazing care.
UCSF Division of Palliative Medicine is dedicated to doing interdisciplinary work. They're dedicated to making a broad and inclusive environment for working. And we've had many of the members of the Division of Palliative Medicine on the Jerry Powell podcast, including Naomi Sachs, Danny Shamas, Cara Bischoff, Carly Zapata, Steve Pantelat, and Mike Rabo, among others. This is a terrific group of people, and I think you'd love to work with them.
And if you're interested in learning more about the business, then please check out our show notes and click on the link. And best of all, if you take the job, you can hang out with me and Alex. What's better than that, Alex? Nothing. This episode of the Jerry Paul podcast is CME eligible.
To claim credit, please go to the CME tab on jerrypal.org.
Welcome to the Jerry Powell podcast. This is Eric Wadera. This is Alex Smith. And Alex, we are going to be talking about slow codes today. You may have heard of a partial code, show codes, light blue codes, placebo codes, Hollywood codes. We're going to talk about what that is. But before we do, who do we have on with us to talk about this great subject?
We are delighted to welcome Gina Piscitello, who's a palliative care doc at the University of Pittsburgh. Gina, welcome to the Jerry Powell podcast.
Thanks for having me.
And we're delighted to welcome Parker Crutchfield, who is a bioethicist at the Western Michigan University Homer Stryker School of Medicine. Parker, welcome to the Jerry Powell podcast.
Hi there. Glad to be here.
And we're delighted to welcome Jason Wasserman, who is also a bioethicist at Oakland University's William Beaumont School of Medicine. Jason, welcome to Jerry Pal.
Hey, thanks.
Great to be here.
So we got a lot to talk about. The ethics of slow codes. Are they ever okay? Maybe a little defense of the slow code. But before we go into that... Jason, do you have the song request or is it Parker who has a song request for Alex?
Parker.
Parker! Yep. What song are you going to request today?
Stop in the Name of Love by The Supremes.
Why did you decide to pick this song?
Well, I thought of it from the perspective of the patient who, instead of a slow code, might be getting a full, sincere code that they don't want and might eventually
break their heart as well. I love it. And I love the Motown. Having grown up in Michigan and East Lansing and went to Michigan, I love a little bit of the Supremes. So here's a little bit.
Baby, baby, I'm aware of where you go Each time you leave my door I watch you walk down the street Knowing your other love you'll meet But this time before you run to her Leaving me alone in her Think it over Think it over Stop in the name of love before you break my heart Stop in the name of love before you break my heart Think it over, think it over
That
was wonderful.
That's
a
perfect song. I love it.
I feel like we should applaud, but I don't know if that messes your audio up.
Well, we're going to think over slow codes, whether we should stop doing them, how often we're doing them. But before we get into that, maybe we can actually define what is a slow code. Again, you may have heard of this as partial codes, show codes, Hollywood codes. Jason, what is a
slow code? yeah so uh there's kind of two uses of the term i mean technically like in a in a narrower sense a slow code is a situation in which a team takes its sweet time responding to an arrest because they're motivated by or they have a reticence to resuscitate the patient so they kind of take their time because they don't really want to engage in full board cpr because
the walk don't run there yeah exactly
right so one of my colleagues earliest experiences in medical school his first code blue he comes running out of the room running towards the stairwell busting through the door and he looks over and is attending is you know reading a paper and waiting on the elevator
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Chapters
8 chapters
1
What are slow codes and how are they defined in clinical practice?
0:00–6:59
2
How prevalent are slow codes in hospitals according to recent surveys?
6:59–14:24
3
What are the main harms to patients, families, and clinicians from slow codes?
14:24–21:07
4
How do state laws and litigation fears influence the use of slow codes?
21:07–26:00
5
How does the trolley‑problem thought experiment apply to slow‑code decisions?
26:00–31:43
6
What arguments support slow codes as a harm‑reduction strategy?
31:43–37:53
7
Why do some clinicians view slow codes as ethically unacceptable?
37:53–43:33
8
What practical recommendations emerge for navigating slow codes in real‑world settings?
43:33–49:53
Speakers
3 identifiedMore from GeriPal - A Geriatrics and Palliative Medicine Podcast
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