A recent investigation has revealed that 'Do Not Resuscitate' (DNAR) orders are being issued to elderly patients without proper discussion or consent, often leaving families unaware. The practice has emerged as an unintended consequence of an NHS initiative encouraging over-65s to make advance care decisions.
The 'frailty project' aims to create an index of 12 million Britons over 65, scoring them from one (fit) to nine (terminally ill). However, critics say it has turned into a coercive system, with 'clipboard zealots' visiting fit and healthy older people unannounced to discuss end-of-life care.
One case involved 93-year-old Lucy Jeal, who received a surprise visit from a 'frailty nursing practitioner'. During an hour-long discussion, he raised the prospect of treatment being withheld. The next day, she received an A4-sized notice with a red border stating she should not be resuscitated if her heart stopped.
Mrs Jeal, who does her own shopping and cooking, was scored three on the frailty index. She described the notice as an 'Orwellian diktat' and said: 'If I collapse, they are refusing to put me together again.'
Hundreds of readers have contacted the Mail, expressing anger and distress at what they perceive as pressure to agree to DNAR orders. Some feel they have been issued a death sentence, while others describe it as 'euthanasia by the back door'.
The irony is that the initiative may not be practical. A form completed when a patient is fit may have no bearing on a future clinical situation. Experts stress that DNAR orders should only be made after careful discussion with patients and families, based on a specific clinical context.
