Do Not Attempt Resuscitation (DNAR) Decisions in the ... - aagbi

7. The law provides a clear hierarchy in terms of legal standing
to make DNAR decisions:
a. The competent patient’s direct instructions.
b. The patient’s advance decision or proxy decision maker
if competence is lacking.
c. The senior clinician in charge of the patient’s care, acting
in the patient’s best interests, if there is not a legally valid
advance decision or proxy decision maker for a patient
lacking competence.
8. If, after discussion, there is no agreement on which DNAR
decision option should be adopted, the decision of the
person with the legal right or responsibility for making the
decision should be accepted.
9. If an anaesthetist or other health care provider cannot agree
with the outcome of the review of the DNAR decision, they
must ensure that arrangements are made for another
suitably qualified colleague to take over the role in
accordance with GMC guidelines.
10. If it is unclear who has the right or responsibility to make
the decision, or if there is doubt over the legal validity of an
advance decision or proxy decision maker, or doubt as to
what is in the best interests of the patient, then seek legal
advice immediately.
11. In an emergency, the doctor must make decisions that they
view to be in the best interests of the patient using whatever
information is available.
12. The DNAR management option should, under most
circumstances, apply for the period when the patient is in
the operating theatre and recovery areas. The DNAR
decision should be reinstated when the patient returns to
the ward, unless in exceptional circumstances.
3