European Resuscitation Council Guidelines 2025 Ethics in Resuscitation

Abstract

These Guidelines of the European Resuscitation Council (ERC) on Ethics in Resuscitation provide evidence-informed recommendations on the ethical considerations of resuscitation, focusing on advance care planning, the involvement of bystanders and first responders, family presence during resuscitation, termination of resuscitation, and ethical considerations for systems, education, research, and low-resource settings. The recommendations in this chapter are informed by the Consensus on Science and Treatment Recommendations (CoSTR) by the International Liaison Committee on Resuscitation (ILCOR), focused reviews by the ERC Ethics Writing Group of the ERC Guidelines 2025 on Ethics in Resuscitation, and expert consensus within the writing group. We have emphasised considerations for out-of-hospital cardiac arrest, in-hospital cardiac arrest, and paediatric cardiac arrest throughout the guidelines. These guidelines aim to ensure that resuscitation decisions are made in alignment with patient values and preferences, and they emphasise the importance of a patient-centred approach to care. The Guidelines also address the balance between beneficence and autonomy, stakeholder involvement, transparency and the use of artificial intelligence in resuscitation research, and the multiple aspects for education in ethics in resuscitation.

Keywords: Advance care planning; Bystander; Cardiac arrest; Cardiopulmonary resuscitation; Education and systems; Ethics; Family involvement; Low-resource setting; Organ donation; Research ethics; Resuscitation; Suicide; Termination of resuscitation.