The primary goal of health care is to benefit patients by restoring or maintaining their health as far as possible, thereby maximising benefit and minimising harm. If treatment fails, leads to more harm or burden than benefit (from the patient’s perspective), ceases to benefit the patient, or if an adult with capacity has refused treatment, that treatment is no longer justified.

Prolonging a person’s life usually provides a health benefit to that person. Nevertheless, it is not appropriate to prolong life at all costs with no regard to its quality or to the potential harms and burdens of treatment or to the patient’s wishes. The decision to use a treatment should be based on the balance of risks and benefits to the individual receiving the treatment. This principle applies to any treatment, including cardiopulmonary resuscitation (CPR).

The guidance identifies the key ethical and legal principles that should inform all CPR decisions. The high-level ethical principles are the same for all people, in all settings, but differences in clinical and personal circumstances make it essential that all CPR decisions are made on an individual basis.