to think this is disgusting and wrong

[threeOrangesocksmorgan]

here
surely the man and his family should have had a say before this was put in place .
how can it be right?

Murder that's what it is, if it happened and why is it still perfectly fine to abort a baby that's found to have it.

There are far worse conditions to be born with yet the only test and pressure is about DS.

I agree that it should have been discussed, I just don't agree that a decision not to perform CPR in the event that a person with dementia has a cardiac arrest is necessarily discrimination against that person.

So would you be happy if say your partner had a condition that limited his mental capacity, he went into hospital, and unbeknownst to you the doctors issued a DNR for him?

I agree with you mellen.

I've worked on a care of the elderly ward for many years now, Dementia is a cruel illness that you never recover from, and many do have a poor quality of life. That's why the decision to put a DNR order on that person is made.

I think the issue here is the family not being included in the decision.

It would be interesting to know how long into the patients stay in hospital the decison was made. It says in the article that they were unable to contact the Next of Kin.

I'm sure there is probably more to this than what is being reported. There usually is.

The reason it is discrimination is that his disabilities - Down's Syndrome and learning difficulties - were listed as reasons for the DNR. If the reasons given had been those of his physical health (leaving aside the doctors' failure to discuss with the patient and his family) and he just happened to also have DS, that would not have been discrimination. Dementia isn't even included on the list of reasons according to the BBC report.

I came on here to post this exact link, OP. I am disgusted and saddened by it, but in some senses not too surprised, as what Cailin says is true and is the attitude of many people, not just towards DS but towards many people with disabilities. Drain on resources, don't contribute, all that. And don't get me started on the welfare reform bill in the light of all this.

:( Just sickeningly awful

This also could be a case of poor documentation by the Medical team on the DNR form. There should be an investigation into what is written in the inpatient medical notes as usually these are more detailed.

Cailain

Yes, if my husband had dementia so severe that he needed to be PEG fed (which tbh also raises questions, because if I had dementia I wouldn't want anyone giving me a PEG either), then I would be horrified if anyone would attempt CPR in the event of him having a cardiac arrest.

Yes the issue here isn't DNR; sometimes that is warranted- but family always needs to be consulted.

Having nursed someone very elderly with no living close family left and in constant pain, I have no wish to be left in that way; however the fact that I have an underlying ASD is not relevant and my family would need to be invovled- even if it was just grandkids left.

How relevant a PEG is depends. My children have no need of them but as we have many friends whose children do require them, they have become normalised to us and not any great fear.

The issue is as OptomsticPesimist says
Hs Downs Syndrome and learning difficulties *were listed as reaons' for the DNR.

If it is 'administrative' it is a pretty fucking massive error.

I'm not frightened of PEG's, especially in the context of a stable, long term condition. I just know that if I had a dementing illness I would not want a PEG. If I had had a different reason for needing one eg a stroke that had led to swallowing problems then I would be quite happy to have one.

a PEG feed is not an issue here surely, in my life they are normal.
but DNR siting ds and LD's as a reason is so wrong.
people posting, oh I wouldn't want to be resuscitated is missing the point.
as I assume you would want to be consulted at some time, or make the decision using a living will.
this man was not consulted. nor were his family.

That's how you feel, mellen, which is fair enough. But I'm not in favour of a system where doctors can decide on a DNR without asking a patient's family. Considering euthanasia is forbidden even if the patient themselves want it, it seems odd that doctors can then decide of their own accord not to resuscitate a patient without his family's knowledge. It seems scary to me.

I'm not missing the point, I said that there should have been consultation, with whoever was appropriate to consult with.

IMO the issue if whether to resuscitation or not should be for more frequently discussed so that people in hospitals are not subjected to a an attempt at CPR if the circumstances suggest that it will be futile. CPR just isn't that successful. And a DNR order is not the same as saying 'withhold all treatment and let the person die'.

I saw this - it's awful.

I can't begin to imagine how that family would have felt if he had died, it's terrible. Knowing that his learning disabilities/Downs were listed as 'reasons' is beyond awful.

Btw, I believe DNR covers oxygen tubes as well as CPR, doesn't it? Is that right?

Oxygen tubes? Not specifically. If someone has a chest infection or COPD and needs oxygen they would still get it. If they had a cardiac arrest and resus wasn't being started then oxygen wouldn't be used.

Ah, ok. When my gran was dying they said if she got to the point of needing oxygen in a tube down her throat, they wouldn't do it if she had a DNR. But perhaps they meant it would only happen if she had cardiac arrest, and I missed that bit.

Sorry, not really on topic, I just feel awful for that family. I don't see how whether or not CPR works well is an issue here.

There is often a discussion about how far people would want to be treated, for example if someone would want treatment for a chest infection if they had severe dementia. The point that I was trying to make is that DNR is a very specific question - saying 'should CPR be started if there is a cardiac arrest', it shouldnt in itself imply that you withdraw or withhold other treatment.

but there wasn't a discussion that is the whole point.
if there had been there wouldn't be a problem.

"The instruction not to attempt resuscitation in the event of a cardiac or respiratory arrest was issued without his family's knowledge."

so no discussion!

Yes, exactly.

And IMO the point is, if this decision was taken without discussion with the family, and with the reasons given being the man's Downs, then you do naturally worry about the integrity of that hospital over providing any treatment. It's serious.

it does make you wonder how often this happens.
I do hope the family are successful in this case as then it might bring about change.

Yes, I think that we all agree on that.

glad to hear that.