Do Not Attempt Resuscitation Orders: Guidelines

Jim Shannon Excerpts

Wednesday 21st July 2021 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Gentleman on bringing this issue forward. When I saw it on the agenda for Westminster Hall, I just knew that I had to be here. As light is spread, Members like me had the same idea. That is why I wanted to be here. During the first wave of the pandemic, there were ongoing issues with DNAR orders. It has been stated that human rights may have been violated in over 500 cases. That is an enormous amount. Every one of us knows people who have found themselves in those difficult positions. The hon. Gentleman made a critical point: when decisions are made for DNAR orders, full protocol must be followed. Most importantly, the next of kin, who really need to know what is going on, have been ignored. That cannot happen again.

[Martin Vickers]

The hon. Gentleman makes some powerful points, particularly, as I just mentioned, about the involvement if not of the patient themselves, certainly of the next of kin.

There have been examples of elderly people who reported that they felt pressured into signing these orders against their will. On 16 June, the Daily Mail reported that research carried out by the University of Sheffield found that 31% of the patients in its study who were admitted to hospital for covid were issued with do not resuscitate orders. That is unacceptable. Decisions of that nature are for the individual. They have the right to make their decisions without feeling unduly pressurised.

There have also been reports of care home residents having these orders imposed without consent and some reports speak of “blanket use”, which again is completely unacceptable.

Another report was of a 76-year-old man being issued a DNAR order following a heart attack, from which he made a full recovery. The order had not been discussed beforehand, but when his wife protested, she was reportedly told to “let him go with dignity.” The situation was only put right after the intervention of a more understanding member of staff and the order was revoked.

Throughout the pandemic, there have also been distressing reports of disabled people being denied vital medical treatment. According to the charity Mencap, a number of disabled people have died prematurely when intervention could have saved their lives. However, such intervention was denied owing to DNAR orders that should not have been in place.

Suffice it to say that some of the stories I have heard are frankly sickening, especially those involving the disabled or those suffering from mental illness. Having said that, I do not want to identify individuals in specific cases, although one widely reported case referred to a former Member of the European Parliament, which is sort of halfway to identifying the person involved. However, as I say, that case has been public for some time. She was admitted to hospital in Oxford for an operation on a broken pelvis. After being discharged, she was, of course, shocked to discover that a DNAR order had been in place, without her knowledge or consultation. In the event, her heart stopped during the procedure, supposedly owing to the fact that she suffers from Parkinson’s disease.

I am sorry to say that, as a result of reports I have read, I am able to come to no other conclusion than that clinicians are making assumptions regarding their patients’ quality of life and chances of survival that frequently are harsh and unnecessary. It is evident that a robust response is required from the Department of Health and Social Care. Any delay is unacceptable.

Ministers from the Department have rightly offered reassurance. However, it is time we saw action. Best practice guidelines are already in place, having been set by the Resuscitation Council UK. However, the examples I have given clearly show that the guidance does not appear to have been adhered to by some clinicians.