Addenbrooke’s Hospital is at the heart of a legal challenge over their ‘Do Not Resuscitate’ policy

Addenbrooke’s Hospital is at the heart of a legal challenge over their ‘Do Not Resuscitate’ policy.

The family of Janet Tracey, who died in March 2011 are seeking a national policy over ‘DNR’ consultation. A ‘Do not Resuscitate’ notice was placed on her records but it was cancelled five days after it was challenged by her family. A second notice was put in place with the agreement of her family two days before she passed away. Her widowed husband, with the support of the Equality and Human Rights Commission, mounted a legal challenge against the first notice. The hospital is accused of breaching the human rights of Mrs Tracey, who was terminally ill at the time because doctors failed to consult her before the decision was made.

Addenbrooke’s Hospital argued that there is a general desire to consult, but that in Mrs Tracey’s case, the discussion did not take place to spare her the distress.

In 2012, High Court Judge Mrs Justice Nicola Davies ruled that the first DNR order had minimal effect on Mrs Tracey because it was cancelled. However, in 2013, the Appeal Court decided there should be a full hearing as the matter is of wider public importance. Now the debate into whether patients have the right to be consulted and the right to a second opinion are to be determined by the Court of Appeal judges.

Rosaline Wong, a medical injury solicitor at Ashtons Legal, has represented families who have had first hand experience of having a Do not Resuscitate order recorded in their medical notes without either their knowledge or consent. In 2013, she settled a claim against Luton & Dunstable Hospital NHS Foundation Trust when a DNR order was imposed on John Burr without his consent or a discussion with his relatives. Mr Burr was erroneously fed despite being kept on Nil By Mouth as he had difficulty in swallowing. He was not actively resuscitated because a DNR order was placed in his medical records. He later died from inhalation pneumonia.

Last year, an 82 year old pensioner who was waiting for an operation at York Hospital to change a kidney stent accidentally became aware that there was a DNR order in his records.

Rosaline Wong commented: “I am very concerned by the use of DNRs on elderly or disabled patients simply on the basis of their age or disability. In situations where patients are very ill, discussing the appropriateness of a DNR order is going to be very difficult, but there is no reason why discussions should not take place. National guidelines issued by the British Medical Association and the Royal Colleges say that DNR orders should only be issued after discussion with the patient or their family, but there are ample examples across the country that the guidelines are not adhered to. Patients with capacity have the right to be consulted and this fundamental right cannot be overruled. Inappropriate use of the DNR orders could result in the refusal of treatment of patients whose lives could significantly benefit from resuscitation.”