Do not resuscitate orders:
September 02, 2011
Posted by:Catherine Bell
Doctors must not have the only say
Current policy which allows treatment that can potentially prolong life to be withheld without the consent or knowledge of a competent patient is an affront to basic human rights. The final decision not to resuscitate may lie with the doctor, but the views of the patient (and arguably their family) must be accorded proper respect.
The family of Janet Tracey who died in Addenbrooke's hospital after a "do not resuscitate" order was put in her medical notes without her knowledge, removed on her objection and then reinstated again without her consent (or it is claimed the family's) are seeking to judicially review the policies that allowed this to happen.
Janet Tracey's case is not an isolated one. I have handled several similar enquiries from the family members of patients who were shocked to discover that Do Not Resuscitate Orders had been instigated by medical staff without any discussion or consultation having taken place.
It has been clearly established that under English law doctors cannot be required to give treatment against their clinical judgment. Following the case of Lesley Burke in 2005, the GMC considers that doctors have no legal or ethical obligation to agree to a patient's request if they consider the treatment was not in the patient's best interests. However whilst there can be no obligation to try to prolong life in the face of medical futility, there must surely be a duty to inform the patient and their family that such a decision is contemplated.
As the population ages, an increasing number of deaths are take place in hospital with do not resuscitate orders in place. It is important to ensure that these decisions are taken neither hastily or lightly. Doctors should offer patients and their families the opportunity to discuss the reasons for the decision and if possible into seek a second opinion.