Commission calls for clear national and local guidance on Do Not Resuscitate Notices
6 May 2014 02:35 PM
Health workers should not be allowed to breach
the human rights of vulnerable patients, and their family members, by
preventing them from being involved in any decision about resuscitation, the
Equality and Human Rights Commission will say
today.
The Commission is
intervening in a Court of Appeal case which revolves around whether seriously
ill patients and their loved ones have the right to be consulted about the use
of Do Not Resuscitate Notices (DNR).
The
case (Tracey v Cambridgeshire NHS Foundation Hospital Trust) involves a
terminally ill woman who had a DNR notice placed on her notes, with neither her
nor her family’s knowledge, by doctors at Addenbrooks
hospital.
She objected to it when
she found out and it was removed, only to be replaced with another a few days
later. She died without being resuscitated within a few days of the second
notice being placed on her notes.
The Commission believes
that being able to make a decision about whether a person’s life is worth
living is a fundamental right protected under Article 8 of the Human Rights
Act, which covers respect for private and family life and extends to personal
autonomy relating to decisions about life or death. Such decisions
should, where possible, rest with patients rather than be taken by doctors
alone.
The Commission is the
national body that promotes and enforces the laws that protect everyone’s
right to dignity and respect. In its submission to the Court, it will
argue that where it is considered unlikely that Cardiopulmonary Resuscitation
(CPR) will be successful (that is, it will not restart the heart and breathing)
then patients with capacity should be told that this is the view. They
should be advised of their right to a second opinion and where they do not have
capacity their family or advocate should be consulted. It should only be
in exceptional circumstances that the patient's opinion is not
sought.
The
Commission will argue that, equally, where a clinician considers CPR might work
then the patient's views as to whether or not a DNR Notice is used should
also be integral to the decision.
The
Commission will further call for clear and consistent national and local
guidance which uses understandable terminology so that patients can give
informed input.
Addenbrooks said at a previous hearing that out of the
68 per cent of the population who die in hospital, 80 per cent have DNR
notices. However, the Department of Health does not collect these figures
centrally.
Rebecca Hilsenrath, Chief Legal Officer for the
Equality and Human Rights Commission, said:
“Human Rights laws exist to protect everyone.
Being consulted, where possible, on whether our life is worth living is a
fundamental right we should all expect.
“Health professionals of course have a valuable
role in providing advice, but this should not lead to preventing someone from
exercising choice in respect of their life or death.
"The Commission is intervening in this case to
ensure that patients' human rights are not breached by a lack of clear
policy, and that decisions about carrying out CPR are made in the light of the
patient’s wishes. Decisions should not be made solely by
clinicians, although the ultimate judgement is theirs."
For
more press information contact the Commission’s media office on 0161 829
8102, out of hours 07767 272 818.
Notes to Editors
• The Commission is a statutory
body established under the Equality Act 2006, which took over the
responsibilities of the Commission for Racial Equality, Disability Rights
Commission and Equal Opportunities Commission. It is the independent
advocate for equality and human rights in Britain. It aims to reduce
inequality, eliminate discrimination, strengthen good relations between people,
and promote and protect human rights. The Commission enforces equality
legislation on age, disability, gender, race, religion or belief, sexual
orientation or transgender status, and encourages compliance with the Human
Rights Act 1998. It also gives advice and guidance to businesses, the
voluntary and public sectors, and to individuals.