For Em10

[naomi24]

You may remember a couple of weeks you spoke about a hospital taking a decision, without consulting the family, not to resuscitate a patient. At the time I said I was surprised it happened. Now I’m not. A family member is currently in hospital, and I spoke to the consultant yesterday who TOLD me that in the event of sudden failure, they would not attempt resuscitation. Whilst I agree that this would be the right thing to do, it is the first time I haven’t been asked to make a decision. Perhaps it’s become common practice. I don’t know – but I just thought I’d tell you. x

[rowanwitch]

It isn't the family who decide although their feelings should be sought as regard the likely choice of the patient . If a patient is able to make the decision themselves the family may not be asked at all. Strong religious imperatives may affect the decision process as well but it is far more likely the consultant will have the final say.

[naomi24]

Rowan, I've been in this situation several times - and, until now, have always been consulted. The medical staff haven't mentioned it to the patient - who is currently capable of making a decision - they simply told me they would not do it. I'm not complaining - I agree with them that in this instance it would be the right thing to do - but I know Em was upset by it when her loved one was involved, so I simply thought I'd tell her that her experience is not unique.

[emmie]

Naomi
thank you, as i said before, from the consultant, nursing staff no one in fact had asked if my o/h or us should have a DNR sign on his bed. They were all useless, the consultant arrogant and not available to speak with when the time came. And the nursing staff were poor to poorer, sorry i can't find a better word. I have relatives who have worked in nursing, one still does, and this according to him goes on all the time.

[naomi24]

I'm so sorry you had such a bad experience, em, but the DNR policy, without consultation, does appear to be more widespread than I first thought. x

[emmie]

without wishing to sound as though i know it all, that wasn't, isn't my intention, but from the same sources i believe the practice is widespread.
a junior doctor gave a larger dose of morphine to relieve his pain, which effectively ended his life. It was and is the biggest trauma i have ever endured, there have been others, but this one isn't something i will ever get over.

[naomi24]

That's been common practice for a very long time, em. I have experience of that too - but in every instance, I thought it was the right thing to do.

[bednobs]

no one can consent or decline treatment on behalf of another adult, unless they have POA, so it's only good practice to inform relatives of decisions like this which are made in the patient's best interest, not a "must" and it is lawful. It is also lawful to give a large dose of morphone to relieve pain, even if you know it's going to speed the end of someone's life - it's called the doctrine of double effct

[boxtops]

My big fear when my mother was in her last days - aged 94, having had a good life - was that the staff attending her would feel obliged to attempt to resuscitate her. Thankfully, they didn't, but it would have been the last thing she would have wanted.

Some years ago when I worked in the hospice, the ambulance crew bringing patients to us had an obligation to resuscitate if patients arrested, our then consultant had to issue a specific directive about each patient to DNACPR if they were on their way to us. It's different now - each Trust has a whole set of protocols to follo.