Paramedics are to be told if a patient does not wish to be resuscitated or wants to die at home, under plans backed by ministers.Adults in Britain can legally refuse medical treatment, even if it leads to their death but doctors cannot undertake treatment to a patient if it clashes with any clinical judgment.
Patients should, however, be given an opportunity for a second opinion wherever possible.
While the General Medical Council (GMC), the doctor’s watchdog, said last year there was no absolute obligation to prolong life, the medical profession does have a final say about whether resuscitation is in the patient’s best interest.
This has led to accusations from some critics who believe doctors are “playing God” and ignoring vulnerable patients’ right to life.
It has also prompted fears that as hospitals face deeper budget cuts, not resuscitating patients will become a cost-cutting option. It is thought that four in five people who die in hospital are the subject of “do not resuscitate”(DNR) orders.
Cardiopulmonary resuscitation (CPR) attempts to restore breathing or blood flow to those whose heart has stopped beating or who have stopped breathing.
It can include using electric shocks to try to correct the rhythm of the heart, repeatedly pushing down firmly on the patient’s chest and inflating the lungs with a mask or tube inserted into the windpipe.
While television medical dramas suggest it is often successful less than a fifth of those who have had such treatment actually go home, according to the British Medical Association (BMA). Inevitably, the young and fit are more likely to survive than the frail and elderly.
In 2007 the BMA, together with the Resuscitation Council (UK) and the Royal College of Nursing, issued joint guidelines on the issue in a 25 page document titled “decision relating to cardiopulmonary resuscitation”.
Legal experts say the “do not resuscitate” advice is essential where a “patient or their family disagree with doctors about whether a particular treatment is futile, a burden rather than a benefit, or inappropriate”.
Roger Goss, the co-director of Patient Concern, has raised concerns previously that “do not attempt resuscitation” orders are being misused.
“We are concerned that patients are having “do not resuscitate” written on their notes without they or their relatives knowing,’ he said earlier this month.
‘Bearing in mind NHS budget cuts over the next few years, it is not far-fetched to foresee that “do not resuscitate” orders will proliferate to the point where everyone over a certain age — perhaps 65 or 70 — gets one stuck on them.”
In England, Andrew Lansley, the Health Secretary, has stopped short of a national policy.
