Heroic measure

Cardiopulmonary resuscitations (CPR) serves as a popular example of a heroic measure. CPR is an emergency potentially life-saving procedure used when a person's heart stops beating or is not breathing that involves chest compressions and rescue breathing.[2] While CPR can be considered a standard of care in the healthcare setting, it is often seen as a last-ditch attempt to save a person's life in an emergency. Suppose a person suffers cardiac arrest and is not near adequate medical attention, CPR can be seen as the only viable option to revive the person. Potential consequences of CPR include sternum fracture, rib fracture, lung contusion, artery rupture, and hemorrhage, but even so, CPR may be medically necessary when the alternative option is death.

Amputations of limbs may be considered heroic measures but necessary in situations which call for drastic measures. In the event that a limb gets physically crushed or is damaged beyond repair, the only way to save the patient may be to remove the affected limb. For example, persons with diabetes are at risk of nerve damage if they consistently have high blood sugar.[3] This leaves the affected area at risk for infection and if severe infection occurs and the infected limb is not removed, it can infect the rest of the body which will most often lead to death. This is also the case with people who leave dangerous infections untreated, the tissue of that limb will begin to die leaving amputation as the only way to save the person from sepsis as the infection spreads to the rest of the body.[4] However, one can argue the use of a prosthesis after amputation would disqualify this method as an heroic measure but there are also limitations & negative consequences to prosthesis use.[5] This is more prevalent in isolated areas where medical attention is very far away.

Oftentimes, treatments like chemotherapy and radiation are also considered examples of heroic measures. Chemotherapy is a treatment that uses drugs to target and destroy rapidly-growing cells, like cancer cells.[6] Radiation therapy uses high-energy x-rays to kill cancer cells.[7] In medicine, chemotherapy and radiation is commonly used to treat cancer. Though it can be a very effective treatment for cancer, it does not come without its side effects—some of which are more serious than others. For example, some common side effects of chemotherapy and radiation include: fatigue, hair loss, nausea and vomiting, diarrhea, skin changes, and more.[8] These side effects occur because chemotherapy and radiation kill not only cancer cells, but also normal, healthy cells in the body as well.[9] Some more serious side effects that can also occur as a result of these treatments is damage to other organs in the body like the lungs, kidneys, nerves, heart, or reproductive organs.[10] It is even possible for a second cancer to develop many years after chemotherapy.[10] Although chemotherapy and radiation are commonly used as cancer treatments, there is potential harm to the body that can occur as a result of these treatments. However, sometimes there are no other treatment options available to treat the cancer and it is necessary to use chemotherapy or radiation in attempts to treat a person with cancer and save their life despite the side effects that can occur.[11]

Often when people with cancer find that experimental chemotherapies are unsuccessful, end-of-life planning begins to start since that is usually the last line of resort for the person.[12] Although there are arguments on whether end of life planning should be considered heroic since it does not prolong or save a person's life, similar to throwing the surrender flag up in the air. However, the topic is still relevant as unsuccessful heroic measures will usually lead to certain death as they are last resort. There has been concern for Oncology providers preferring to introduce end-of-life planning later after attempting all heroic measures when others argue that it should be emphasized before experimental chemotherapy starts[13] Many palliative care advocates argue that more emphasis should be placed offering this care as a viable option for people when deciding whether to try riskier experimental treatments or opt for a safer route of care.