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james bruce
james bruce, Solicitor-Advocate
Category: Law
Satisfied Customers: 5872
Experience:  Owner at James Bruce Solicitors
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I need advice from someone with expertise on UK medical law

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I need advice from someone with expertise on UK medical law about a "Do not resuscitate" order placed on my elderly dad's medical record on the basis of his age and *undiagnosed* early stage dementia. Thank you.
JA: Have you talked to a lawyer about this? In which country do you live? If different, which country is your legal question related to?
Customer: England. No I have not spoken to a solicitor yet.
JA: What steps have you taken so far?
Customer: None.
JA: Is there anything else the Lawyer should know before I connect you? Rest assured that they'll be able to help you.
Customer: I need advice from someone with expertise on UK medical law about a "Do not resuscitate" order placed on my elderly dad's medical record on the basis of his age and *undiagnosed* early stage dementia. Thank you.

Hello, I hope you are well. My name is***** am a solicitor advocate and I will be assisting you with your question today. I am very sorry to hear of the problem you are experiencing and I will do my best to help you with this matter.

Can I please ask you to give me some more detailed information regarding this matter so as to allow me to work with you and help resolve your enquiry.

How may I assist?

Who's decision was it to place the DNR on the record?

Customer: replied 9 days ago.
Thank you, James. My dad is nearly 91 and was admitted to A&E on Saturday after suffering delirium related to a urinary tract infection. Aside from this, he is in very good health for his age, except he is only able to walk small steps. I did report a general short term memory issue and his recent neglect of his appearance to the hospital. Based on this the consultant decided a DNACPR is appropriate; the doctors believe if he ever need resuciation his cognitive state would decline further.

So your father has not made this decision and was healthy before going into hospital and only little memory loss.

It is important to know that you do not have the right to demand CPR from the  doctors, regardless of the circumstances.

Doctors may decide to impose a DNR order on a patient even without their consent.

There are however processes which a doctor must follow when making this kind of DNR decision. Also, such a decision can only be made on one of the following grounds:

Where the prospects of successfully carrying out CPR are so low it would make any attempt futile.

Or,
Where the doctor considers that CPR would not be in the best interests of the patient.
This could cover situations where any possible negative effects from the CPR would outweigh the benefits, or where successful CPR would just serve to prolong a patient’s suffering /lower there standard of life.

Unfortunately and sorry to say this, with the NHS in meltdown, these decisions are being made where they consider the advantages are outweighed by disadvantages and thus they can free up a needed bed.

Customer: replied 9 days ago.
Thanks, James. I am aware that drs have the discretion to withhold DNR, but my understanding is it's unlawful for doctors to make that decision on the basis of age and dementia; am I correct?
Customer: replied 9 days ago.
If I can argue that to the hospital, they are more likely to remove the DNR. Thanks.
Customer: replied 9 days ago.
Also, the "dementia" has not been diagnosed and prior to this incident my dad was living a very independent life.

Correct, age should not come into it. Neither early stage dementia.

Further, if they failed to discuss this with the patient and family first, they could be breaking the law and be breaching your fathers human rights.

Advise then of this and that you will consider suing them if it is not removed.

Customer: replied 9 days ago.
Thanks, that's great - I will!

Article 8 of the European Convention on Human Rights requires that DNR decisions (also known as 'do not attempt cardiopulmonary resuscitation', DNACPR) are taken in consultation with a patient or their family, that patients know in advance how decisions will be made and what to do in a disagreement.

This actually goes back to a 2014 Court of appeal case where it was established that a hospital broke the law by not doing this.

The threat of legal action against the NHS trust and the doctor may make them rethink.

Thank you for using Just Answer and for allowing me to assist you with your legal enquiry. I am pleased I was able to be of assistance. Please do not hesitate to come back to me for further advice on this or any other legal matter. It will be my pleasure to be able to assist you again.

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