Consult dying patients on whether to resuscitate, doctors advised

Hospital bed - credit Mark Hillary​

Dying people should be more involved in decisions over whether they should be resuscitated towards the end of their life, according to new guidelines.

Doctors and other care professionals are now advised to discuss the choices about whether to attempt CPR with the patient, and if they want, their wider family.

A do not resuscitate order instructs care providers not to intervene if a patient’s heart stops beating or if they stop breathing.

Under the revised guidelines, patients should always be involved in the decision, unless they lack capacity to engage with the conversation. In that case, families, guardians or welfare attorneys must be involved.

The changes to the national policy on DNACPR (Do Not Attempt Cardiopulmonary Resuscitation) follows reviews by doctors and nursing unions as well as guidance from the General Medical Council.

Attempting to use CPR when it will not help someone can cause pain and distress for family members, the advice says.

Mental health Minister Maureen Watt said end-of-life care should be consistent across the country.

“Whether or not to attempt CPR towards the end of someone’s life is one of the most emotive and sensitive decisions that patients, doctors and relatives will ever have to face and this policy identifies the key importance of conversations with patients and families.

“Supporting staff in all health and social care settings to have these sensitive discussions is of the utmost importance.

“Treatment options must be discussed honestly and the patient’s wishes must be taken into account where possible. The option of a dignified death must be open to everyone in all circumstances.”

The Chief Medical Officer and Chief Nursing Officer will be writing to health boards informing them of the updated policy and offering helpful resources for staff, patients and families.