New advice on ‘do not attempt resuscitation’ orders follows concerns over ‘blanket’ use in pandemic

The new legal action was threatened by Kate Masters, whose late father David Tracey brought a successful judicial review in 2014 which established that a DNAR notice issued to his late wife Janet without her or her family’s knowledge was a violation of her human rights.

Ms Masters said she was concerned that DNARs were being imposed in “seemingly blanket ways” without consultation with patients or their families.

She had signalled her intention to apply for permission for judicial review of Health Secretary Matt Hancock’s failure to issue clear national guidance or a directive to ensure that patients’ Article eight rights in relation to DNARs are protected.

In her legal letter to Mr Hancock, Ms Masters provided examples of DNARs being made without consultation and said concerns about their wrongful use were a result of him delegating resuscitation policies to a local level during the pandemic.

The Government has now said it will publish two documents to ensure patients and families understand how DNAR decisions are made in light of the pandemic.

One document will be for patients and their families, setting out matters such as the right to be involved in the decision and how to request a review, while the other is for NHS staff. Both will be published on the NHS website.

Davina Hehir, the director of policy and legal strategy at Compassion in Dying, which supported the move, said: “This is a victory for common sense.

“Coronavirus has highlighted and exacerbated ongoing problems concerning accurate and accessible national guidance regarding CPR, the lack of which has contributed to a proliferation of poor and unlawful practice during the pandemic.

“We know that many patients who express a wish to protect themselves from potentially harmful or futile CPR are not supported to do so, and equal distress is caused when a DNACPR decision is not thoroughly and sensitively explained to a patient and their family.

“Both scenarios completely undermine person-centred care at the end of life, and risk jeopardising sensible efforts to demystify CPR decisions and improve communication between doctors, patients and families around end-of-life decisions.”

A Department of Health and Social Care spokeswoman said: “We have made clear that it is completely unacceptable for DNACPR orders to be applied in a blanket fashion to any group of people.

“The Government has taken consistent action on a number of fronts to prevent this from happening and NHS England is currently creating patient-facing guidelines on how to challenge a DNACPR and access support.

“This work was already under way and is not a result of legal action.”

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