Misuse of Do Not Resuscitate orders is national scandal costing lives – Martin Vickers

However, the seemingly widespread use of Do Not Attempt Resuscitation (DNAR) orders over the course of the Covid pandemic has persuaded me to speak out.

Having read of a research project carried out by the University of Sheffield which revealed that 31 per cent of the patients in the study who were admitted to hospital for Covid were issued with DNAR orders, I was appalled; it is, 
quite simply, unacceptable. Decisions 
of that nature are for the individual and they have every right to consider such matters without feeling unduly pressurised.

I do not doubt that the medical professionals involved are acting in the best interests of their patients, but decisions of this kind must be made only after discussions with the patient or, if the circumstances demand it, their next of kin.

However, a report published by the Care Quality Commission (CQC) found that almost 10 per cent of DNAR decisions had been made and communicated inappropriately, involving potential breaches of individuals’ human rights.

Decisions regarding our own mortality can be uncomfortable, obviously for ourselves but also for our loved ones, and this issue highlights the need for a cultural shift to ensure that everyone feels supported to hold open and honest conversations about what they would like to happen at their end.

It is only by doing so that we can be sure that our wishes and those of our loved ones are honoured, as well as reducing the distress of the relatives of patients who have chosen to have DNAR orders in place. Sadly, we do not yet have this culture.

There have been examples of elderly people who reported that they felt pressured into signing these orders against their will or even where they have been issued without their knowledge. One report was of a 76-year-old man issued with a DNAR order following a heart attack.

The order had not been discussed beforehand, but when his wife protested, she was reportedly told to “let him go with dignity”. The situation was only put right after the intervention of a more sympathetic member of staff and the order was revoked. Fortunately, the patient made a full recovery, but this could have so easily had a very different outcome.

Furthermore, throughout the pandemic, there have also been distressing reports of disabled people being denied vital medical treatment. According to the charity Mencap, a number of disabled people have died prematurely when intervention could have saved their lives. However, treatment was denied owing to DNAR orders that should not have been in place. This is a huge injustice which has caused unnecessary grief for so many families.

It is with regret that I have been able to come to no other conclusion than that some clinicians are making assumptions regarding their patients’ quality of life and chances of survival that frequently are harsh and unnecessary. It is by no means the majority of medical professionals, but the issue has become so significant that I felt compelled to raise the matter in Parliament.

As a result, Ministers have now accepted the CQC’s recommendations for the creation of a Ministerial Oversight Group. This is a positive start, but they must commit to the group including health and social care providers in the palliative and end of life care sector, as well as local government and voluntary and community organisations.

The over-use of DNAR orders over the course of the pandemic is a national scandal. Reports suggest that there are people not with us today who otherwise may have been and, likewise, some of the lucky ones who made a full recovery did so despite having one of these orders attached to them.

We all recognise that medical professionals face extremely difficult decisions. This issue deals with profound matters: the relationship between doctor and patient, and for many like me, who regard human like as sacred, the orders go against our deepest religious and spiritual beliefs and cannot be dealt with in a matter-of-fact way.

It cannot be allowed to go on.

Martin Vickers is Conservative MP 
for Cleethorpes.

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