Concern over making of 'do not resuscitate' decisions during the COVID-19 pandemic
30 March 2021
Concern over making of 'do not resuscitate' decisions during the COVID-19 pandemic
The Care Quality Commission (‘CQC’) has reported that more than 500 people were put on do not resuscitate orders without appropriate consent during the coronavirus pandemic.
This follows an interim report in November 2020 which revealed that increasing pressure during the pandemic coupled with a lack of rigid guidance may have led to decisions concerning do not resuscitate orders “being incorrectly conflated with other clinical assessments around critical care”.
A do not resuscitate order tells healthcare professionals not to perform cardiopulmonary resuscitation (CPR) if a patient stops breathing or their heart stops beating. A doctor will record the order in the medical record after a discussion with the patient, or in appropriate cases with their carer, and it is agreed that this is what the patient wants.
The study revealed that "From the beginning of the COVID-19 pandemic, there were concerns that 'do not attempt cardiopulmonary resuscitation' (DNACPR) decisions were being made without involving people, or their families and/or carers if so wished, and were being applied to groups of people, rather than taking into account each person's individual circumstances".
It is concerning that even after the CQC report there are an unknown number of unlawful DNACPR orders still in place. Amnesty International has called for a robust instruction that all care providers should review all such orders created since 01 March 2020.
Kenneth Lees, specialist Clinical Negligence Solicitor at Curtis Law said:
“It is a fundamental right for an individual to make decisions about their own health and whether to accept treatment or not. A patient can only provide informed consent to the proposed treatment if the medical provider discloses information on the treatment, test or procedure in question, including the expected benefits and risks, and the likelihood that the benefits and risks will occur. The advice should be specifically tailored to the individual patient and their circumstances. The treatment should only then progress if the patient voluntarily grants their consent without coercion or duress. Where a patient lacks capacity, the decision must be made by a family member or carer unless there is a medical emergency. Anything short of this may possibly give rise to a claim for financial compensation for lack of informed consent.”
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