Resuscitation in Oncology: Limits, Ethics, Practice, and Humanity

Introduction: Cardiopulmonary resuscitation (CPR) is one of the most consequential decisions in clinical medicine—a pivotal moment between life and death where science, ethics, and humanity intersect. Although advances in systems of care, technology, and training have refined technique and logistics, outcomes do not consistently result in meaningful, neurologically intact survival. In oncology—where disease trajectories are heterogeneous, treatment burdens substantial, and organ reserve often limited—these tensions are especially pronounced. Methods and approaches: This manuscript examines resuscitation as a medical, ethical, and human process, with explicit focus on patients with cancer. We review contemporary strategies for early recognition of deterioration (MEWS, NEWS, MET activation), team preparedness through Immediate Life Support (ILS), and structured decision-making at the boundaries of resuscitation. We also address communication with patients and families, the legal framework of Do-Not-Resuscitate (DNR) orders, and the distinctions among treatment forgoing, palliative sedation, and euthanasia, emphasising oncology-specific considerations such as metastatic burden, treatm