Do Not Attempt Resuscitation (DNAR) Policy - Dudley Primary Care ...

Summary Sheet
Every patient has the right to die in peace and with dignity and there will
inevitably be cases where resuscitation following cardio-respiratory arrest
cannot be justified on medical or quality of life grounds, as being in the
patient's interests.
It may also be against the clearly stated wishes of the patient to prolong what
the patient sees as a poor quality of life by attempting Cardio-Pulmonary
Resuscitation (CPR).
Such cases should be clearly identified and all staff involved in the patient’s
care should be made aware of the action to take in the event of cardiorespiratory
arrest.
The aim of this Policy is to:-
• Ensure that clinicians understand the key ethical and legal issues that
are used as a framework to inform decisions about CPR and when not
to resuscitate a patient.
• That clinicians clearly document these decisions using the required
paperwork.
• That these decisions are clearly and correctly communicated to all
other providers and outside organisations that may be involved in the
patient’s care.
These guidelines do not address the complex legal, ethical and clinical issues
that surround some cases and in this instance clinicians are advised to seek
further guidance and support from senior management. This policy relates
specifically to Do Not Attempt Cardio-Pulmonary Resuscitation and does not
replace the existing Dudley CPR Policy (2009). Neither does it refer to other
life sustaining treatments.
This is a Trust wide policy for the attention of all clinicians and it is
recommended it is read in conjunction with the following local and national
documents:
Decisions relating to cardio-pulmonary resuscitation. The revised joint
statement from the British Medical Association, Resuscitation Council (UK)
and the Royal College of Nursing (2007)
Resuscitation – Do not resuscitate orders position statement. Nursing and
Midwifery Council (2000)
Withholding and withdrawing Life Sustaining Treatment- Guidance for doctors.
Good Medical Practice (2006)
End of Life Care Strategy (DH 2008)
End of Life Care Pathway (West Midlands Clinical Pathway Group 2008)
Dudley PCT Baseline Review of Services for End of Life Care (DH Operating
Framework 2007/08)
Advance Care Planning: A Guide for Health and Social Care Staff (NHS End
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