In the chaos of a prolonged resuscitation, it can be easy to lose sight of the human story unfolding behind the curtain. It is well documented in the literature that family members who are present at a resuscitation and a loved one’s death will often experience better psychological outcomes in hand with less depression, anxiety, and PTSD. The value of being able to witness a passing has been thought to help loved ones make sense of a loss, offer a sense of closure, reduce feelings of helplessness, and promote meaning.
Unfortunately, as it is well known to emergency teams, particularly in hubs of tourism, tragedies happen when least expected and typically when family members are not present. So, how does this opportunity to involve loved ones in end-of-life transitions extend into virtual platforms such as FaceTime? With technology mitigating the barriers that distance might hold, video platforms may offer providers the ability to connect compassionately with patient’s families while delivering shocking and difficult news.
The utility of this was recently highlighted during a prolonged resuscitation in a young adult. This young male was on vacation and suffered a sudden cardiac arrest, likely secondary to a PE given the clinical scenario. Resuscitation efforts lasted around 1 hour and attempts to contact loved ones were made. Upon reaching his parents, they were appropriately reactive and having a hard time understanding how their healthy child had left their home and might die on vacation. With the family’s permission, connection via FaceTime was made so the parents could witness the efforts being made by the care team, for the mother to see her son’s face one more time and for her to say goodbye. A student was able to hold the phone and just as any other scenario in which a patient’s loved one was welcomed into a resuscitation, this patient’s parents were welcomed to express their feelings and watch as time of death was declared. Mom later expressed a sense of gratitude and closure that did not seem attainable prior to video streaming.
While the benefits of FaceTime are apparent, on a technical note, FaceTime is not HIPAA compliant. It offers a fast and easy opportunity in emergency situations and can be used relying on the “confidential communications exception” within HIPAA. Avoid using any PHI when discussing the case with family and request that family is alone in a private location for the call. When utilizing the exemption, it is advised to put the request to receive confidential communications via FaceTime in writing. It’s imperative to warn the individual that FaceTime lacks the administrative controls to comply with HIPAA, and request that the individual acknowledges the warnings surrounding breaching security of PHI. Given that these would classically be emergency situations, weigh the risks and appropriateness of these conversations in the specific situation. Use situational context to assess safety and awareness around how we utilize virtual tools. If a TeleHealth or IT Secure video streaming platform is available at your institution, this would take precedence. Look to your hospital IT security leadership for guidance or consider Zoom for Healthcare or Doxy.me. Further, it is important to note that video calls may be screen-recorded or either intentionally or unintentionally broadcasted. Given the risks of misinterpretation of these critical moments and the growing integration of social media features into communication apps, such as live streams, consider the privacy, dignity and safety of your patient before initiating or sharing any communication.
When considering real-time video calls in these scenarios, please also consider how cultural and individual factors might influence these decisions or if witnessing a traumatic or poorly managed death might increase distress. Prepare a loved one for a video call in a similar manner as you might prepare them for what to expect during a code in an in-person scenario. Always give your team a heads-up and make sure everyone is on board and prepared to welcome a loved one into the room.
As technology evolves, we must also evolve and learn how to better serve our patients with all available resources. Particularly in busy tourist hubs, virtual platforms may offer opportunities for loved ones to be offered a sense of closure and move through grief when losing family members separated by distance. When delivering difficult news on the phone, don’t be afraid to hit that video option if consent is given.
References
- Steinhauser KE, et al. Factors considered important at the end of life by patients, family, physicians, and other care providers. JAMA. 2000 Nov 15; 284(19):2476-82.
- Schulz R, Boerner K, Klinger J, & Rosen J. Preparedness for death and adjustment to bereavement among caregivers of recently placed nursing home residents. J Palliative Med. 2015, Jan 26 18(2),127–133. https://doi.org/10.1089/jpm.2014.0309
- Barry LC, & Prigerson HG. Perspectives on preparedness for a death among bereaved persons. Conn Med. 2002 Nov. 66(11), 691–696.
- Prigerson HG, et al. Prolonged grief disorder: Psychometric validation of criteria proposed for DSM-V and ICD-11. PLoS Med. 2009 Aug;6(8):e1000121.
- HIPAA Guide. Is FaceTime HIPAA compliant? 2024 Oct 29. Accessed Nov 14, 2025.