On the 17th June 2014, the Court of Appeal ruled in a key decision regarding the use of ‘do not resuscitate’ notices (DNRs).  Judges have found that the failure by doctors to discuss the use of DNR notices with a patient or their family, is a breach of the patient’s human rights.

Mrs Janet Tracey died at Addenbrooke’s Hospital in Cambridge in March 2011 as a result of a neck fracture she sustained in a car crash two weeks earlier.  At that time Mrs Tracey was preparing for the last year of her life, having recently been diagnosed with terminal lung cancer.

Given the extent of her injuries, doctors placed a DNR notice in Mrs Tracey’s medical records, thinking that they were acting in Mrs Tracey’s best interests.  However, the doctors failed to consult Mrs Tracey or her family.  Lord Dyson, Master of the Rolls ruled that this violated Mrs Tracey's Article 8 right to respect for private life by failing to involve her in the process.

This is a key decision regarding the circumstances in which doctors should use DNRs, which have in the past been extremely controversial.  The judgment effectively imposes a duty upon medical professionals to consult with a patient or their family before putting a DNR order in place.

It is already well established that neither a patient nor their family can require a doctor to administer treatment which that doctor does not consider to be in the patient’s best interests. However, doctors must consult others who are looking after the patient, or are interested in his or her welfare.

So although today’s judgment does not really change the law, it does provide certainty for doctors and highlights the importance of family involvement where a patient’s life and future health are at risk.  Although the decision to withhold treatment is emotionally difficult for both the patient and their loved ones, that decision should only be taken once the patient or their family members have been consulted.

John Kowalewski, Clinical Negligence Paralegal