A friend and colleague was recently admitted to a Glasgow hospital for treatment over a few days. The NHSWhile in the receiving ward a nurse was going through his medical records and said “I see you have DNR marked down?”. He asked what this meant and was taken aback to be told.This had never been discussed with him or any family member; and as a patient, he had full legal capacity to give consent to medical treatment.
If you’re in hospital you’re there for medical treatment; if you’re seriously ill or undergoing a lifesaving procedure and have legal capacity why wouldn’t a doctor or nurse obtain your views and consent on the issue of resuscitation? The CQC has expressed concern over the relationship between poor practice and the unprecedented pressure on the NHS. The found poor record keeping, and a lack of oversight and scrutiny of decisions being made – importantly, these problems pre-dated the pandemic. As regards the pandemic, the use of DNR decisions during Covid-19 are within the terms of reference of the UK Covid-19 inquiry and indeed the Scottish Covid-19 public inquiry.
Her husband David brought a judicial review in the English High Court. He sought to clarify whether there was a legal duty to inform patients with capacity whether a DNR had been placed on their record and whether they had any right to be consulted about it. Lord Dyson, the Master of the Rolls, said: A “DNACPR decision is one which will potentially deprive the patient of life-saving treatment, there should be a presumption in favour of patient involvement. There need to be convincing reasons not to involve the patient.”