Death Language for Code Status Discussions

(CODE-EMRS Trial)

This trial explores how different ways of discussing CPR (a procedure to restart the heart) affect patient decisions about whether to opt for it if their heart stops. Specifically, it examines whether using straightforward language about death, known as "Death Language," influences patients to decline CPR. Participants will fill out electronic surveys and have the opportunity to discuss their choices with doctors. The trial is suitable for individuals over 65 who can read and speak English and are not currently in intensive care. As an unphased trial, it offers participants the chance to contribute to important research that could enhance communication about critical healthcare decisions.

The trial information does not specify whether you need to stop taking your current medications. It seems focused on communication and decision-making rather than medication use.

A previous study showed that the way doctors discuss code status—whether to perform life-saving measures—can influence patient choices. Research suggests that when doctors use direct language about death, patients might be more likely to choose a "do not resuscitate" (DNR) order compared to when they use more neutral language. Although no direct evidence exists about the safety of using this kind of language, it's important to know that participating in these studies involves no physical risk. The focus is on communication and decision-making, where participants simply answer questions about their medical treatment preferences in case of a serious health issue. This means there are no safety concerns related to medical procedures or treatments.¹²³⁴⁵

Researchers are excited about this trial because it explores how the language used in medical discussions about cardiopulmonary resuscitation (CPR) can influence patient decisions. The trial compares "death language," which directly mentions the possibility of death without resuscitation, to standard language that does not. By examining how these different approaches affect decision-making, researchers hope to gain insights into improving communication between healthcare providers and patients, potentially leading to more informed and personalized care choices.

Research has shown that the words healthcare providers use can influence decisions about do-not-resuscitate (DNR) orders. In this trial, participants will encounter different language styles to assess their impact on decision-making. One group will hear straightforward language about death, which earlier studies found makes patients more likely to choose DNR. This approach helps patients better understand the situation, including the fact that CPR (cardiopulmonary resuscitation) succeeds only about 1 in 7 times. Patients often make better decisions when they know the possible outcomes, such as brain and organ damage, even if the heart restarts. Clear communication is essential to help patients make choices that align with their values and wishes.¹⁶⁷⁸⁹