Resuscitation needs justice: an intersectional view on justice, equity, diversity, and inclusion

Disparities in cardiac arrest survival persist across gender, race, age, disability, socioeconomic status, and geographical location in part due to unequal access to life-saving interventions such as bystander cardiopulmonary resuscitation (CPR) and early defibrillation. Inequities in access to training, equipment, and local implementation may reinforce these disparities across the chain of survival. Current diversity, equity and inclusion (DEI) approaches to disparities in resuscitation research often examine inequities in isolation, limiting their ability to explain how structural, social, and institutional factors interact to influence outcomes. To address these limitations, this concept paper proposes examining the chain of survival through an intersectional lens, which considers Justice at the forefront of Equity, Diversity, and Inclusion (JEDI). Adding justice as an ethical principle aims to target these broader factors, and when combined with DEI efforts, may lead to a more comprehensive approach on examining inequities in resuscitation. Within the European Resuscitation Council (ERC), this intersectional JEDI lens provides a support for identifying inequities and barriers across both the chain of survival and the formula of survival, including medical science, educational efficiency, and local implementation, so that giving and receiving high-quality resuscitation becomes realistically attainable for everyone.