Doctors were wrong to place a ‘do not resuscitate’ (DNR) notice on a patient’s medical records without consulting the patient or the patient’s family, judges have ruled.
Medics at Addenbrooke’s Hospital initially placed a DNR order on 63-year-old Janet Tracey, but were forced to remove it after the family complained. However, a second DNR order was later issued with familial consent.
Guidelines for doctors had recommended involving the patient and family members in such decisions, but this landmark ruling by the Court of Appeal now makes it a legal duty.
Lord Dyson, Master of the Rolls, who presided over the case, stated that the hospital trust “violated Mrs Tracey’s Article 8 right (under the European Convention on Human Rights) to respect for private life in failing to involve her in the process which first led to the notice”.
In the judgment, he said: “A Do Not Attempt Cardiac Pulmonary Resuscitation decision is one which will potentially deprive the patient of life-saving treatment, there should be a presumption in favour of patient involvement.
“There need to be convincing reasons not to involve the patient.”
Mrs Tracey died three years ago and her husband David has since battled through the courts to seek clarity over DNR notices and consent.
Speaking after the judgment Mr Tracey said: “We’re all so pleased that the Court has agreed that imposing a do not resuscitate order on Janet without consulting with her was unlawful.
“It feels as though the wrong done to Janet has been recognised by the Court and the fact that her death has led to greater clarity in the law gives us all some small comfort.”
A spokesperson for Leigh Day, the law firm representing the Tracey family, said: “The Judgment sends a clear message to all NHS Trusts, regulatory bodies and healthcare professionals that patients have a legal right to be informed and consulted in relation to decisions to withhold resuscitation.
“The belief such information would cause distress is no longer a sufficient reason not to inform and consult with a patient. There must now be convincing reasons to displace this right.”
Dr Keith McNeil, the head of Cambridge University Hospitals NHS Foundation Trust, which oversees Addenbrooke’s, said: “Today’s ruling hinges on a specific point of law. There was no criticism of our clinical care.
“It is a fact of life that every day people die in hospitals. From my own experience as a specialist hospital doctor, the most important thing is that these patients are treated with the utmost respect and dignity.”