TOKYO >> Last month, Tokyo Fire Department began allowing its ambulance staff to halt cardiopulmonary resuscitation and transportation to a hospital if a terminally ill patient declines treatment.

The change is aimed at respecting a patient’s choice to spend their final moments at home. Ambulance staff will be allowed to stop lifesaving measures if family members of the patient agree and a doctor can confirm the decision.

As Japan faces a graying population, the new approach is likely to spread across the nation.

According to the fire department, the new protocol applies to patients who are adults in cardiopulmonary arrest and have decided the issue with family and their primary-care doctors. Ambulance staff must be able to confirm doctor’s consent. In such a case, a patient will be left in the hands of family members, and a doctor will confirm the patient’s death on the scene.

Previous rules required ambulance staff to treat patients and transport them to a hospital.

Emergency transportation of elderly people to hospitals has been steadily rising.

According to the Internal Affairs and Communications Ministry’s Fire and Disaster Management Agency, in 2017, 70% of the 127,000 people in cardiac arrest transported by ambulances were in their 70s or older. In numerous cases, family members asked ambulance staff to withhold resuscitation.

Continued appeals lead Tokyo’s fire department to review its procedures. Last summer, 11 of 816 cases involved patients protesting CPR.

Protocols vary among the country’s fire departments, since the central government has not created a policy on the issue.

According to the agency, 100 of Japan’s 700 firefighting entities withhold resuscitation based on a doctor’s instruction.