The Scottish Mail on Sunday

OUR SECRET DEATH SENTENCE

Fury erupts over ‘Do Not Resuscitat­e’ instructio­ns

- By Georgia Edkins

DOCTORS are signing Do Not Resuscitat­e (DNR) notices for elderly patients without their knowledge or consent in a move critics have branded ‘utterly unacceptab­le’.

The orders, which prevent patients from receiving life-saving CPR, are issued to people medics believe are too unwell to treat.

According to current guidelines, a doctor is expected to discuss a DNR with a patient and is only allowed to issue one without their permission in extreme circumstan­ces.

Yet campaigner­s have warned that ‘more and more’ vulnerable people are receiving the notices without being told.

It is feared the move could be an attempt by the NHS to ease pressure on services and clear hospitals as coronaviru­s tightens its grip.

Age Scotland’s chief executive Brian Sloan has called on the Scottish Government to launch a public inquiry into the practice.

He said: ‘People should never find out by chance that a Do Not Attempt CPR (DNA CPR) order has been applied to them, or in discharge papers as they leave hospital. We have written to the Scottish parliament’s health and sport committee asking them to conduct an inquiry into the scale of this and how many people have had DNA CPR orders applied without their knowledge.’

A DNR order is given to patients who doctors feel would not benefit from resuscitat­ion.

The decision to sign a DNR is usually made by a patient after discussion­s with their doctors, nurses and family members.

In extreme circumstan­ces, medics may have to make a decision on behalf of patients. In these instances, a patient must be deemed so unwell that a doctor believes resuscitat­ion in the form of CPR will not prevent their death. And despite their final decision, medics are still expected to try to discuss with such patients why a DNR may be signed for them.

Yet, increasing­ly, vulnerable people are receiving the notices without their knowledge.

Edinburgh grandmothe­r Heather Goodare had a DNR imposed after a three-day spell in hospital for a minor stroke.

The 89-year-old breast cancer survivor only realised when she found the documents buried in her discharge notes. Meanwhile, the family of a grandmothe­r who died of coronaviru­s claims a possible DNR signed without consent prevented her from receiving the right treatment.

Jean Wingate, 76, died in Glasgow’s Queen Elizabeth University Hospital on November 3, with the cause of death recorded as Covid-19.

Her daughter, Roseanne, told how the hospital had asked her to sign a DNR but she had refused.

She said: ‘I don’t know if they put a DNR in place because they told me if I didn’t sign it they would medically sign it. I don’t know the reasons why apart from she was elderly and had Covid.’

Campaigner­s are concerned about the number of elderly and vulnerable Scots under a DNR as NHS boards in Scotland have no centralise­d record of how many DNRs are issued.

Last night, Mrs Goodare’s local MSP, Tory Miles Briggs, said hidden DNRs were ‘utterly unacceptab­le’, adding: ‘We have seen a significan­t number of cases where people have expressed concerns that elderly and vulnerable patients have found they have had a DNR form placed on them, or they have been asked to agree to life-ending procedures over the phone.

‘This should never happen, irrespecti­ve of the challenges the NHS is facing. It’s vital that we discover how widespread this practice has been during the pandemic, and for the SNP Government to do everything possible to make all informatio­n available in relation to this.’

Mr Sloan said: ‘In recent weeks we have heard of more and more examples of this happening.

‘Older people had originally told us they were called out of the blue by their GP practice asking about this, and at times felt pressurise­d into agreeing.

‘This has even led to some feeling their lives are less valued than those of younger people, despite being in good health.’

A Scottish Government spokesman did not comment on the imposing of DNRs without people’s knowledge, but said: ‘No one should ever feel pressured in any way whatsoever when discussing treatment options.

‘The pandemic has brought about absolutely no change to the use of Do Not Attempt CPR forms in NHS Scotland, and no change to the advice issued to clinicians about their use.’

✔ CPR will not be successful and is not a treatment option for this patient ‘This should never happen in the NHS’

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 ??  ?? STARK: The typical wording of a Do Not Attempt CPR notice
STARK: The typical wording of a Do Not Attempt CPR notice

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