To at least have discussed DNR decision with family

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Been to a meeting today with social services re: dad moving into nursing home from hospital. At the end of the meeting the ward sister took me and my brother to oneside and told us there was a do not rescusitate order on my Dad's notes. Apparently the consultant has taken this decision without any consultation with either dad or family. Dad is not on end of life pathway but has a progressive illness, though not expected to die in the near future.

Is this out of order or am I just being naive?

Well, if someone had decided not to bother resuscitating my Dad after heart attack number 3 I wouldn't be here. If they hadn't bothered after heart attack number 5 he'd have missed my graduation.

I'm still pissed off that I had to insist they at least attempt to resuscitate when he actually did die. He'd made it plain that he wanted to die 'kicking and screaming' rather than just be allowed to go, and I made sure he got his wish.

Sometimes a DNR may be in the best interests of the patient. However, sometimes it may go against everything the patient wants, and what they have articulated. I don't think it should be presumed that the patient is ignorant of what resus involves - some patients are more clued up about their conditions and various complications than the doctors treating them.

I have a lot of respect for the medical profession in general, but I don't think this is a decision that can be taken in isolation.

whatsthecat thats the whole point. It needs discussing with families. Its not so clear cut. I have discussed it with my family, and taken a variety of scenarios into account. So for me it would depend on the circumstances. For my DP he would be totally with your dad. Hopefully this will encourage a few more people to have discussions with their families before they get too ill and emotions takeover

As flyover says, it needs discussing. Clearly with your Dad whatsthecat CPR was successful and he continued to have a quality of life. With a Lot of people though, the medics made a decision based on the medical prognosis - it would be unsuccessful for a lot of people and it traumatic to put people through it that being the case. The challenge is that that decision needs to be made ahead of time rather than in the moment. But I do agree that when families come in to ask about someone's medical condition they should also be told about DNR status and if the decision has been taken not to resuscitate, then why that decision has been made.

We had the opposite with my Mum. She had incurred cancer, she had very little quality of life anyway and she was adamant she didn't want to be resuscitated if she got to that point (and she did). It meant she could slip away peacefully which is what we all wanted for her.

It's not about whether the consultant was right that the patient is a DNR. The problem is that he made a decision and didn't discuss it with the patient or the family.

This sort of thing needs discussing. At a calm time when everyone has a chance to think about the realities of the situation.

A doomed-to-fail resuscitation does not give dignity in death. But nor does family members (who had no idea about the DNR until 30 seconds earlier) screaming at doctors to do something and the doctors being unable as they (wrongly) believe that the DNR was the patients wish.

My granny had DNR on her notes, by her request. When she had a massive heart attack they did resussitate her becasue her relations hadn't also agreed to it even though they knew she had little quality of life.

She lived another year after that. that was a year where she had lost all memory due to multiple strokes, had dementia in fairly advanced form, had little mobility and was incontinent. She recognised some people vaguely as a friendly face, but not who they were or what relation they were to her.

Resussitating her, whereas my Uncle was thrilled that she had been and was horrified to find DNR on her notes, took away that dinity she always said she wanted to die with. DNR did not mean that she didn't receive any treatment she needed, nor did it mean that at any time she was not treated with love and care.