DNR Letter

[Orangeblossom78]

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

It’s not good timing but in some countries they have this discussion with all relevant people at the relevant time. Only 3% of ICU entries in the Netherlands are over 80 because they have a culture of people saying they want to die at home and not at hospital. This will save a lot of younger lives.

Personally though I think any old person who has dared to mutter things like “if I get it I’ll die I don’t care” should be listened to when it comes to choosing who gets a ventilator.

I'm not saying the discussion is wrong, while ther opppaite. That letter was appalling, and sending it out to 8 year olds is a travesty.

'We are encouraging all our patients to consider the approach to treatment options, should you unfortunately become ill with the covid 19 virus.

The options usually available are x,y, and z,
but we understand they won't be the best option for all our patients. Depending on how the illness progresses in individuals, not all options may be available, if, for example sustaining life can only be effective for a short amount of time.

Within the current setup, you do have a right to opt out of certain treatments/life support. If you feel this is an approach you would be likely to take, or you would like more information, please read the accompanying leaflet, and complete the attached form.

If you have any questions at all, please contact us and we will organise a telephone call at a mutually convenient time.'

Something like that? Took 10 minutes for me to type. Granted, not perfect, but 10 minutes and no medical qualifications; they should have come up with something a damn sight better than that letter they put out.

Agree that there's nothing wrong with advising people to think about it and have that conversation with their families, but the wording of the letter is appalling.

As a doctor I agree it reads very poorly and must be really distressing to receive.

But with the scale of the problem and short time available, I can see the rationale behind it.

I think this is a large part of good palliative care anyway now in the U.K., unfortunately in the cases of CV they are trying to pre empt this because people can deteriorate so quickly. HCP are really worried about not being able to provide good end of life care and this conversation needs to happen at some point but sending out a mass comms is just a dreadful way of managing it

Yes, i agree with housemd, the wording was all wrong, could have been much better

It's dreadfully worded. It's also worth thinking about. I talked to my (shielded, severely frail) DH and we updated both our advance directives. I have reviewed the outcomes of resuscitation and decided against it in my case. He has chosen to ask for it, despite his chances of survival being almost nil. That's his right and I will support and defend his decision as I expect him to support and defend mine.

Also we found this site helpful: compassionindying.org.uk/library/

Asking people to think about what they would want in that situation is sensible, but apart from the fact that it's horribly insensitive, the wording of the letter makes it sound like the hospital has decided to put DNACPR orders on vulnerable patients without their consent