The Lemon Fool

I have a hand written card from my wife's Aunt, saying that she does not wish to be resuscitated. It is signed, but not witnessed and It references 2 other people who also have such cards.

Will a hospital take any notice of wishes written down this way? If not, is there a better way?

I would think the NHS would anly accept an official DNR form, which can be obtained from the GP. Mum had one, which was kept by the front door and always went with her to the hospital when she needed the paramedics,

--kiloran

hiriskpaul wrote:I have a hand written card from my wife's Aunt, saying that she does not wish to be resuscitated. It is signed, but not witnessed and It references 2 other people who also have such cards.

Will a hospital take any notice of wishes written down this way? If not, is there a better way?

I believe that it is entirely up to the hospital whether or not to issue a DNR notice. They did it with my mother without asking me, the next of kin.

However the consultant did seek me out as soon as he could, and explained the reasoning. I got the sense that he felt more comfortable maintaining the DNR status because I agreed.

Had I made a big fuss, would it have been rescinded? I do not know. But I never got the sense that it was totally up to me to decide. Rather I was guided to the destination that the hospital wanted.

I suspect that in your case the hospital would take some notice of the stated desire. But it is just one of several inputs into the decision making.

kiloran wrote:I would think the NHS would anly accept an official DNR form, which can be obtained from the GP. Mum had one, which was kept by the front door and always went with her to the hospital when she needed the paramedics,

--kiloran

I'm not sure they will only accept an official form, but +1 for getting one. They'll also tell you where to keep it, so that responders will find it. I think ( but this is Scotland ) that using the official form means that hospitals will know it exists, the physical form is for ambulance crews.

Lootman wrote:

hiriskpaul wrote:I have a hand written card from my wife's Aunt, saying that she does not wish to be resuscitated. It is signed, but not witnessed and It references 2 other people who also have such cards.

Will a hospital take any notice of wishes written down this way? If not, is there a better way?

I believe that it is entirely up to the hospital whether or not to issue a DNR notice. They did it with my mother without asking me, the next of kin.

However the consultant did seek me out as soon as he could, and explained the reasoning. I got the sense that he felt more comfortable maintaining the DNR status because I agreed.

Had I made a big fuss, would it have been rescinded? I do not know. But I never got the sense that it was totally up to me to decide. Rather I was guided to the destination that the hospital wanted.

I suspect that in your case the hospital would take some notice of the stated desire. But it is just one of several inputs into the decision making.

Ido not think that strictly speaking it is up to the medics and certainly the hospital should not be ‘issuing’ a DNR notice. Why would they do that. Issuing a notice to themselves? I bet the consultant felt more comfortable getting your agreement. There has been a lot of controversy about this in recent years. Hospitals generally like them because to be blunt, they can then dispose of a hopeless case with a clear conscience, but it is for the patient and/or the close relatives to decide about a DNR notice/ instruction. When my wife had terminal cancer she was asked by our GP how she felt about it and it was clear that it was for her to decide. How could it be otherwise?

Dod

Dod101 wrote:I do not think that strictly speaking it is up to the medics and certainly the hospital should not be ‘issuing’ a DNR notice. Why would they do that. Issuing a notice to themselves?

Good question. I had assumed that the DNR notice was directed to other hospital staff, possibly working nights, that the duty consultant had instructed those other staff not to resuscitate.

Else how would the many staff interacting with that patient know?

In my mother's case the DNR notice was right there on the door to her room, so any staff entering could not miss it, and knew what (not) to do.

Lootman wrote:

Dod101 wrote:I do not think that strictly speaking it is up to the medics and certainly the hospital should not be ‘issuing’ a DNR notice. Why would they do that. Issuing a notice to themselves?

Good question. I had assumed that the DNR notice was directed to other hospital staff, possibly working nights, that the duty consultant had instructed those other staff not to resuscitate.

Else how would the many staff interacting with that patient know?

In my mother's case the DNR notice was right there on the door to her room, so any staff entering could not miss it, and knew what (not) to do.

You have I think answered your own question. It will be with her notes or hanging above the bed or somewhere prominent, anyway.

Dod

When my Dad was in hospital (with what turned out to be a terminal secondary tumour from his prostate) aged 90. He told the staff that he didn't want to be kept alive unnecessarily if he died. The staff discussed it with myself and my Mum in private to check our views and then in the presence of my Dad, and it was added to his notes on the end of his bed.

ex-Community Responder here.

All comments my own understanding,

Firstly the question:

DNR / DNAR (Do not Attempt resuscitation) forms are the official version. Even DNARs might sometimes not be accepted, They do need to be in date, valid for what has actually happened at the time of needing them, and need medical input (need to be signed by a Dr for instance) so cannot be knocked up on the spur of the moment. OTOH when my dad was in hospital they sat and discussed it with him, he agreed and they set one up in short order.

ReSPECT Forms.
https://www.resus.org.uk/respect/respec ... fessionals

ReSPECT stands for Recommended Summary Plan for Emergency Care and Treatment. The ReSPECT process creates a summary of personalised recommendations for a person’s clinical care in a future emergency in which they do not have capacity to make or express choices. Such emergencies may include death or cardiac arrest, but are not limited to those events. The process is intended to respect both patient preferences and clinical judgement. The agreed realistic clinical recommendations that are recorded include a recommendation on whether or not CPR should be attempted if the person’s heart and breathing stop.

Similar to DN(A)Rs and becoming more common. Set up by a medical professional in conjunction with the patient.

As for written bits of paper, "Do Not Resuscitate" tattooed across chests etc. they have no legal standing, but they will be taken into consideration in the moment. It is no-one's interest to start CPR when the outcome is unlikely to succeed, or the quality of life afterwards will be minimal should it succeed. CPR is pretty brutal and not a dignified way to go.


Lions' Message in a Bottle. This is a plastic green and white tub (size of an oversized medicine bottle) that contains a sheet of paper with sections for all sorts of information a medic might need. Drs contact details, next of kin, meds and their locations and a whole lot more. It comes with two green cross sticky labels. One goes on the inside of the front door. Medics will look here for a sticker. If there is one, it indicates that there is a bottle in the house. The other sticker goes on the outside of where it is stored. By convention the fridge is ideal, bathroom medicine cabinet a second best. Meds are not stored in it, so having it in the fridge is not an issue.

I recommend that everyone gets one. The Lions give them away for free. You can often see the Lions promoting it on stands at fetes etc. or get one or more from here:

https://lionsclubs.co/MemberArea/home/l ... -a-bottle/

Doesn't contain actual DNR stuff, but there is a tick box for indicating that something exists.