Reynold was spot on in having to resuscitate the patient as the patient's interests (or your perception of the patient's interests) is paramount not the relatives' wishes. However I can appreciate his difficulty as one can sympathise with the relatives as well. I am in agreement that he would have to at least start trying to resuscitate. Relatives not happy? Too bad, just treat the patient and try to calm relatives down. As a junior doctor, I have a few things to add as I think several posters on this aren't aware of some of the aspects of end-of-life decision. 1) Just because someone calls for an ambulance or for a doctor, it does not mean they want themselves resuscitated. many cancer patients with a 'do not resuscitate' decision already made still need medical care (whether to ease their death or to help prolong life for a few weeks, etc). 2) Cultural sensitivities are a big part in death issues, and by and large, one follows the wishes of the patient first and then the will of the relatives. The grey area in this case is that Reynolds did not know if the patient had expressed any wishes, the relatives aren't clear about the laws about this (as most people aren't) and the fact that there wasn't anyone able to make that decision not to resuscitate. As a doctor, I rarely encounter this problem as I just make the decision to either not resuscitate or to stop an ongoing one. So I got a question for for Reynold: Who else other than doctors are allowed to make 'we shall stop this resuscitation because it is pointless' decision? I had the impression anyone who is leading the resuscitation is allowed to make that decision (even if they aren't medically or even paramedically trained). So... in this particular case, I am curious why Reynolds felt that 30 minutes was a realistic timeframe. 30 minutes is far too long. I have never seen anyone make it out from >20 minutes (if not hypothermic), and most of those 10-20 minutes don't make it past the next few days. And all these figures are of young to junior-geriatrics (<75 years). I have never successfully revived a 90 year old (or seen revived). In view of this, I would have only gone for 2-3 cycles of advanced life support (ALS), ie. 6-9 minutes even in my most optimistic mood. That is certainly a more tolerable duration for the relatives than 30 minutes! It would certainly make any complaints less likely and reassure all parties that it was not just a transient easily reversible episode. Perhaps your ambulance trust has a policy on how long to conduct a resuscitation attempt for in a cardiac arrest of unknown duration. Perhaps that is the guideline to use when negotiating with the relatives? If I was in your shoes as an EMT, I would have told the relatives, "I have no choice but to proceed as I have never met the patient before this and I don't know if this is something which could be easily reversed. However as her prospect of recovery is slim and you are not happy with resuscitating her, I would only proceed for a realistic period". If pushed on what this period is, I would say "it depends on her response but if there is no response, 10-15 minutes." If asked about if she would be transfered to hospital, I would say "if there is any response, she would be". And to top it off, I would apologise: "I am sorry but I have no choice". If they remained obstructionist, I would add "I would rather not have to go against your wishes and your culture, but as I was called here, I am required by the ambulance trust to attempt to revive her." PS. I am chinese as well. PPS. I think that if I was >80, I would only want for the leads to be placed on my chest to ascertain if I was shockable or not. If I was, I would only want 3 shocks. PPPS. I sympathise with the relatives as if I didn't know anything about healthcare, most people have the idea that the relatives would have the final call after the patient.