The family of a woman who died at Addenbrooke's Hospital in Cambridge has won a legal claim that her rights were violated when a 'do not resuscitate' (DNR) order was placed on her medical records without her knowledge or consent. The Court of Appeal ruled that NHS bodies have a legal duty to consult patients before making such decisions.
Janet Tracey, a 63-year-old care home manager, died in March 2011 after breaking her neck in a car accident, having been diagnosed with terminal cancer. Her husband, Dave Tracey, argued that the DNR order imposed without consultation was unlawful. The court agreed, stating that patients have a legal right to be informed and consulted about resuscitation decisions.
Merry Varney of Leigh Day, the family's solicitor, 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.' She added that the belief such information would cause distress is no longer a sufficient reason not to consult.
Nearly seven in 10 people die in hospital, and 80% of those die with DNR or DNAR notices in place. Cardiopulmonary resuscitation can be violent, with risks of rib fractures and brain injury. Although medical staff have the final say, the ruling clarifies that patients with mental capacity must be consulted.
Cambridge University Hospitals NHS Foundation Trust, which runs Addenbrooke's, said it was considering the implications of the judgment. Chief executive Dr Keith McNeil noted there was no criticism of clinical care, but emphasised the importance of treating patients with dignity and having difficult conversations about end-of-life care.
The British Medical Association, Royal College of Nursing and Resuscitation Council had already begun a review of their joint guidance on DNR decisions, with results expected within weeks. Dave Tracey expressed hope that the ruling would prevent other families from experiencing similar distress.
