Is everyone dying to plan?
This is alarming. This is really quite horrifying.
These are extracts from NHS Kirklees Do Not Attempt Cardiopulmonary Resuscitation Policy (DNA CPR) –
It is a stated intention
• to make DNA CPR decisions transparent and open to examination
6.2 There is no ethical obligation to discuss resuscitation measures with patients for whom such a treatment, following assessment is judged to be futile, unless the patient raises the issue.
This is a statement by Resuscitation Council (UK) -
The statement looks into misleading reports on nurse leads making decisions on DNA CPR...
Following misleading press coverage, some confusion has arisen about two statements in the document relating to the role of senior nurses in making decisions about cardiopulmonary resuscitation (CPR). The statements appear in sections 6 and 13 of the document. Erroneous reporting led to some concerns that doctors' opinions could be superseded, patients insufficiently consulted or that inexperienced nurses might make such decisions. Consideration of the statements in the context of the entire document makes clear these are misinterpretations.
This is the document -
The offending sections -
6. Clinical decisions not to attempt CPR
The responsibility for making the decision rests with the most senior clinician currently in charge of the patient’s care, although they may delegate the task to another person who is competent to carry it out. Wherever possible, a decision should be agreed with the whole healthcare team. The overall clinical responsibility for decisions about CPR, including DNAR decisions, rests with the most senior clinician in charge of the patient’s care as deﬁned by local policy. The most senior clinician could be a consultant, GP or suitably experienced nurse. In certain settings an experienced nurse may be the senior clinical decision maker. Examples include nurse consultants or senior clinical nurses working in palliative care.
13. Responsibility for decision-making
The overall clinical responsibility for decisions about CPR, including DNAR decisions, rests with the most senior clinician in charge of the patient’s care as defined by local policy. This could be a consultant, GP or suitably experienced nurse. He or she should always be prepared to discuss a CPR decision for any individual patient with other health professionals involved in the patient’s care.
According to this BMJ abstract, The
And this report in Nursing Times headlines nurses having authority to make decisions.
|- Nursing Times|
Senior nurses should have the authority to make key decisions about cardiopulmonary resuscitation, according to new landmark guidance. Richard Staines investigates
LATEST guidelines from the RCN, BMA and Resuscitation Council pave the way for nurses to make clinical decisions on whether or not to attempt cardiopulmonary resuscitation.
Much of the document, published last week, provides guidance on changes in the law regarding Do Not Attempt Resuscitation decisions under the Mental Capacity Act 2005.
A key difference between this and 2001 guidance is nurses are now considered, in some cases, better placed than doctors to make such decisions – both in setting DNAR orders and in making decisions where there is no such order or circumstances mitigate against one.
Ignorance and confusion reign supreme.
'LCP' nurses abroad the net make blatant claims that they make these decisions without reference to patients.
Do those who make the law also break the law? It would appear to be open to any interpretation that is found convenient.
|- The Telegraph|
And this is the world we live in...