Legal News | 25.03.21
Leaving your health decisions to chance? Do Not Risk it
Over the last week, concerns over ‘do not attempt resuscitation’ (“DNAR”) orders, often referred to as DNRs, made during the Covid-19 pandemic have been widely reported in the press. The Care Quality Commission (“CQC”) has been asked by the Department for Health and Social Care to conduct a rapid review of how DNAR decisions have been made during the pandemic, amid reports that blanket decisions were made for groups of people without consulting the patient or their families.
Whilst the CQC’s investigation is ongoing, these reports may prompt you to review your own wishes and arrangements when it comes to DNARs and, more broadly, life sustaining treatment…
What is a DNAR order?
The term refers to a document issued and signed by a doctor. The document tells a medical team not to attempt cardiopulmonary resuscitation (“CPR”). In the absence of this form, teams will attempt CPR.
A discussion around a DNAR order is often raised by medical professionals if you have a long-term condition or a terminal illness, particularly where it is likely you will have a cardiopulmonary arrest. If you do not have capacity, a medical professional should discuss the matter with your family.
But what if…
• You do not have mental capacity?
If you do not have mental capacity at the relevant time, you will not be able to convey your wishes regarding DNAR to your doctor in the manner mentioned above. Your family may be consulted, although will only be able to convey your wishes if you shared these when you had mental capacity.
• You have more detailed wishes when it comes to life sustaining treatment?
A DNAR only deals with a request not to perform CPR. You may have other wishes when it comes to life-sustaining treatment. For example, some would prefer to be at home rather than hospitalised for end of life care or intervention. Some have a preference for treatments to keep them comfortable, even if such treatments could cause them to die more quickly.
If you are worried about decision-making in the event that you lose mental capacity, or if you have further wishes when it comes to life sustaining care, you can prepare an Advance Decision and or a Lasting Power of Attorney for Health & Welfare Decisions.
• An Advance Decision (previously called a ‘Living Will’) is a way of specifying your healthcare wishes whilst you have mental capacity, to be considered by medical professionals in the event that you lose mental capacity. If validly executed, the Advance Decision must be followed.
• A Lasting Power of Attorney for Health & Welfare is one of two different types of Lasting Power of Attorney (the other is in relation to Property and Financial affairs, see further details here https://wansbroughs.com/news-events/end-of-life-care-decisions/).
In this LPA, you appoint one or more attorneys to make healthcare decisions for you in the event that you lose mental capacity. These decisions can range from welfare decisions (like care home choices) to consenting to or refusing life-sustaining treatment decisions, if you wish.
You can have two separate documents (although care must be given to ensure that there is no conflict between the two). Alternatively, we can include Advance Decision wording within a Lasting Power of Attorney, so that you have one document covering both.
If you would like to make arrangements so that your healthcare wishes can be communicated at the relevant time, please do get in touch with your usual contact at Wansbroughs or email us at firstname.lastname@example.org.