Short Codes Okay - But Not Slow Codes, Show Codes, or Hollywood Codes

Both professional society guidelines and court judgments confirm that clinicians ought not engage in slow codes, show codes, or Hollywood codes. That is deceptive. Clinicians should be open and transparent about what they are doing. They should not pretend to do CPR when they are not.  

In contrast, "short" codes are generally permissible. Still, clinicians wonder why they cannot write a DNR order yet they can forgo CPR in the code moment. Sometimes this is because of the peculiar way in which state laws are drafted. A more fundamental explanation goes to the difference between (1) whether to do CPR and (2) how to do CPR.

The former decision is one that typically rests with the patient. The latter decision rests with the clinician. This is analogous to the lawyer/client relationship. Under MRPC 1.2, the client sets the objectives of representation. The lawyer determines the means of achieving those objectives. 

So, while clinicians in many states may not write a DNR order without patient or surrogate consent, they can still determine, in the moment, that continuing CPR is non-beneficial. They can cease CPR for patient A even though they might have continued it for patient B.