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Do Not Resuscitate Orders Being Ignored

An investigation by the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) has found that doctors are “too quick” to resuscitate patients who have suffered a cardiac arrest, attempting to revive those who have expressly stated they do not want medical intervention.

Do not attempt resuscitation orders

When a person suffers a cardiac arrest in hospital, medical professionals will attempt to revive them using cardiopulmonary resuscitation – known more commonly as CPR. However, some patients will tell doctors that, should they have a heart attack, they do not want to be revived. Instead they would prefer medical intervention to be withheld so they can have a calm and dignified death. If so, a “do not attempt resuscitation” order (DNACPR) should be written in their notes, alerting doctors to their wishes.

On other occasions, if a patient is acutely ill and unable to make decisions, their family and the medical team will have a discussion as to whether or not resuscitation attempt should be performed. If it is thought CPR would be of no benefit because the patient is too ill to respond, a do not attempt resuscitation order will be placed in their notes. Medical intervention should not subsequently be given should the patient suffer a cardiac arrest during the course of their hospital stay.

Failure to respect DNACPR decisions

Whether the decision has been made by the patient or by their family, a DNACPR should be clearly stated in a patient's medical notes. If a cardiac arrest does then occur, medical professionals should refer to their notes and act accordingly; if a do not attempt to resuscitate order is in place, assistance should be withheld.

However, the report by the NCEPOD has found that these orders are being ignored. This is largely because a patient's wishes are not always documented. In fact, out of 44 cases of in-hospital cardiac arrest, only 10% had their CPR status clearly stated in their admission notes, despite almost one in four cases expected to be fatal.

Some patients did have their decisions recorded at a later date. But even so, out of 522 cases, only 122 had their CPR status documented in their medical notes at admission or at a later date. Of these, CPR was given to 52 people who had stated that they did not want a resuscitation attempt. On the other hand, 78% had no documentation about CPR status whatsoever.

Has this happened to you or your loved one?

If you or your loved one has been resuscitated after a cardiac arrest, despite explicitly stating you would like a DNACPR order to be put in place, you may be upset about the state you have now found yourself in. Indeed, some patients who are revived when they do not wish to be go on to sustain brain damage or other serious complications. This will, however, amount to medical negligence, as the actions of doctors will have caused a patient increased pain and suffering. If this has happened to you, you should speak to a solicitor about what action you might be able to take, as it is possible that you are entitled to medical negligence compensation.

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