| Summary: | Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) forms exist to provide immediacy and clarity of instruction in the event of a cardiorespiratory arrest; they are written either at a patient’s request, or because a clinical decision has been made that a patient would be unlikely to survive attempted cardiopulmonary resuscitation. They are extremely common, with around 92% of patients who die in hospital dying with a DNACPR decision in place. While working as a physician in the acute care setting and in intensive care, I became concerned about ethical problems with the use, interpretation and unintended consequences of DNACPR decisions: they were considered in an ad hoc manner; often documented without discussion with patients; and appeared to act as an unofficial triage marker, with patients with DNACPR forms being treated differently from those without them. A review of the literature revealed empirical research which supported my concerns, but a lack of contemporary evidence in the UK about the use or understanding of DNACPR decisions and forms. Supported by my colleague, Dr. Jonathan Fuld, I successfully applied for an NIHR Research for Patient Benefit Grant to conduct research to further assess these problems in the UK setting and to develop and evaluate an alternative approach.
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