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DNR Letter

34 replies

Orangeblossom78 · 01/04/2020 15:49

I think the wording in this letter, is pretty bad. www.bbc.co.uk/news/uk-wales-52117814

Could they have been any more insensitive? Thoughts welcome

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Spam88 · 01/04/2020 15:51

I saw this yesterday, it's not far from me. Absolutely appalling. In what world is it ok to tell people they should refuse medical treatment because otherwise they might be responsible for younger people dying?

Orangeblossom78 · 01/04/2020 16:01

Also it assumes those people are older, they might not be. I have a friend with lung cancer in their 20s, for example.

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ChipotleBlessing · 01/04/2020 16:29

I don’t know. If it’s true then there’s really no way to tactfully say that stuff and realistically it would be best if people thought about it in advance and made plans. If it’s not true then obviously it should never have been sent out.

Orangeblossom78 · 01/04/2020 16:32

I think it could have been worded an awful lot better. makes you think how some doctors are talking to patients

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Wingedharpy · 01/04/2020 17:06

I appreciate that I will be in a minority but, it seems very sensible to me to encourage people to think about these things.
When the crisis is upon you is not the time to start thinking of this stuff.

Some of us have already worked out for ourselves that we would not be offered ventilation due to pre existing medical problems, which is why we are doing our damndest not to get it.

There is no easy way to say these things and, to be fair, the letter does say, more or less, in an ideal world we'd talk to you face to face about this but these are very strange times.

Plexie · 01/04/2020 17:12

There was a thread about this but it was zapped because the pic showed personal details.

I thought it was a fake because I couldn't believe a GP surgery would actually write that. But it's now being reported on the BBC news website so must be true.

kilisibird · 01/04/2020 17:28

I think we have to be as practical as possible. If we distance from the emotion for a while, there is no point in wasting resources on people who have terminal illnesses or those who will not likely survive anyway.

It's a horrible thing to consider, but the help the NHS can give is not infinite.

Menora · 01/04/2020 17:30

It is true that some Gp’s are doing this
It’s quite misguided and insensitive - our doctors have collectively agreed not to do this for these reasons

BrutusMcDogface · 01/04/2020 17:31

FUCK ME SIDEWAYS.

I read that letter thinking, this could be me....or it could be my fil who fits the bill!! Just...............🤯

NotEverythingIsBlackandwhite · 01/04/2020 17:48

I think we have to be as practical as possible. If we distance from the emotion for a while, there is no point in wasting resources on people who have terminal illnesses or those who will not likely survive anyway.
No, let's not remove the emotion. We are emotional beings and, if we lose a generation of loved ones, I don't want to be left among a bunch of people lacking in compassion.

You could say why should we waste resources on anyone? You can't judge who is likely to survive. I read a story yesterday of a man who was prepared by the doctor that he may not survive. He was ventilated and did survive.

If younger people have a greater chance of surviving anyway, why not put all those who are not expected to survive on ventilators and give them a better chance?

Can you imagine the country if we allow a generation to die? FFS, these are our parents and grandparents. I'd prefer to take my chances and give older or more vulnerable people more of a fighting chance.

ChipotleBlessing · 01/04/2020 17:58

The stuff about ventilator rationing is happening whether they send letters about it or not. See the BMA guidance on it today. Personally I would rather be warned and have time to make peace with the idea and have a bit of control by making my own decisions. I think if I was in a group where I knew be ventilators weren’t being used I would personally prefer to stay at home to die. But that would be awful for my kids I think, so for their sake I would choose palliative care in hospital if it was possible.

Wingedharpy · 01/04/2020 18:02

To be fair, there is no mention of age as far as I can see - it speaks of pre existing terminal cancer and life limiting illnesses and untreatable heart and lung problems.

kilisibird · 01/04/2020 18:10

No, let's not remove the emotion. We are emotional beings and, if we lose a generation of loved ones, I don't want to be left among a bunch of people lacking in compassion.

I'm not lacking compassion. I was saying if we looked at it from a practical point of view. You have to remove the emotion to be able to do that.

You could say why should we waste resources on anyone? You can't judge who is likely to survive. I read a story yesterday of a man who was prepared by the doctor that he may not survive. He was ventilated and did survive.

It was people who have terminal illness, so obviously not going to survive and people who have very serious health issues that means they would be very unlikely to survive. There will always be an example of this not being accurate, but ultimately we have to make choices if we do not have resources.

If younger people have a greater chance of surviving anyway, why not put all those who are not expected to survive on ventilators and give them a better chance?

They were writing to people with terminal or significant illnesses, not old people.

Can you imagine the country if we allow a generation to die? FFS, these are our parents and grandparents. I'd prefer to take my chances and give older or more vulnerable people more of a fighting chance.

That's not what this is about. Did you read it?

NemophilistRebel · 01/04/2020 18:11

I think they apologised for sending the letters.
Not too sure if they retracted them

housemdwaswrong · 01/04/2020 18:13

Someone not far from me, received this for her 8 year old daughter. 8. Wrong. I could have put it a million different ways, all better.

NemophilistRebel · 01/04/2020 18:16

Fuck! 8 year old?! What kind of reason would there be behind that?!

housemdwaswrong · 01/04/2020 18:19

CF. Average age of death for a CF sufferer is 37, and increasing yearly especially with new drugs. But no, received the letter. I can't imagine how she feels.

NemophilistRebel · 01/04/2020 18:20

As an average that’s still a 30 year life to go at least though!

superram · 01/04/2020 18:22

I have a medical poa for my mum. I would ask that they do not resuscitate-she has dementia and quality of life physically is good but mentally awful.

housemdwaswrong · 01/04/2020 18:24

Exactly. And that's now!

In ten years time, with the new drug, orkambi, & everything else out there, that's expected to be much much higher.

Who printed that with the girl's date of birth on it and thought it still a good Idea??

anonname · 01/04/2020 18:28

It was me who had the original thread, although I’m not in Wales ... our surgery just popped it on Facebook on Sunday morning and said all patients with any long term health conditions should really sign a dnacpr ... so that could be anything from arthritis to cancer to mild asthma ...

When I phoned the surgery on Monday in a bit of a panic they said ... oh no, we meant patients that have had the letter from the government Hmm ... Even with that it is still bloody dreadful .

I have friends on that shielding list and relatives - people with children , work full time, live very normal lives, have very responsible jobs (eg senior nurse, consultant, lawyer, itu nurse) ... none of whom would see themselves as being likely to die soon or willing to give up!

Orangeblossom78 · 01/04/2020 18:44

there is a mention of age- of sparing the ventilators for a younger, healthier person. I understand the need for such letters but suprised at how they were written

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Orangeblossom78 · 01/04/2020 18:49

The NICE guidance online is different to that though, it is about frailty, (assessing patients in hospital) and gives a good rating to those with long term conditions which are generally managed etc. So it is not very consistent.

Such people would be in category 3 in the pdf below.

www.nice.org.uk/guidance/ng159/chapter/1-Admission-to-hospital

www.nice.org.uk/guidance/ng159/resources/clinical-frailty-scale-pdf-8712262765

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housemdwaswrong · 01/04/2020 18:49

I'm on shielding, that's a pathetic reason. I'm shielding because I take immunosupressants, not because I'm expecting to die in the next 5 years, or even the next 30!

Orangeblossom78 · 01/04/2020 18:50

Summary here www.nice.org.uk/guidance/ng159/resources/critical-care-admission-algorithm-pdf-8708948893

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