The Court of Appeal has ruled that clinicians now have a legal duty to consult with patients if they want to place a Do Not Resuscitate (DNR) or Do Not Attempt Cardio-Pulmonary Resuscitation (DNACPR) order on medical notes.

The case was brought to the Court of Appeal after Mr David Tracey brought an application for judicial review against Cambridge University Hospitals NHS Foundation Trust in relation to the placing of 2 DNR notices on his wife Mrs Janet Tracey’s medical notes at Addenbrooke’s Hospital.

Mrs Tracey was diagnosed with lung cancer on 5 February 2011 and at that time it was estimated that she had approximately 9 months to live. On 19 February 2011 she sustained a serious cervical fracture after a major road accident and was admitted to Addenbrooke’s Hospital. She also developed a chest infection and pneumonia and it was the view of her treating clinicians that it would not be appropriate for her to be resuscitated in the event of cardiac arrest.

When she learnt of the DNR order Mrs Tracey was very upset at the thought that someone else could make a decision and deprive her of potentially life saving treatment should the circumstances require it.

The Court of Appeal found that a “Do Not Attempt Cardiac-Pulmonary Resuscitation” decision is one which would potentially deprive a patient of life-saving treatment. IN addition the Court found that the patient should be involved in this decision.

It was added that there had to be a ‘convincing reason’ not to involve the patient and that by failing to consult Mrs Tracey when placing the DNR notice on her records, the hospital had breached her human rights.

The Court held that causing potential distress to a patient was not a good enough reason not to consult. The Court also found that the use of DNR notices in the absence of a clear and accessible Trust policy would not comply with human rights. Policies should be directed at patients and copies automatically given to them and their families.

Price Slater Gawne have experience in this area and have represented client in this situation. Please feel free to contact and discuss the matter with us. We will be happy to help.