Janet Tracey had terminal lung cancer and then broke her neck in a car accident; she was admitted to Addenbrookes hospital but died 16 days later.
Janet's husband, David Tracey, claims that doctors put a "do not attempt cardio pulmonary resuscitation" (DNACPR) order in her records and then cancelled it after she objected but then put a second order on her notes several days later without discussing it with her. The hospital has disputed the family's account of events.
Mr Tracey claims that the hospital's actions amounted to a breach of their human rights as embodied in the Human Rights Act 1998 in that Janet was deprived of her right to life and was subjected to degrading treatment and that he was denied respect for his personal and family life. He is seeking a judicial review of the actions both of the Cambridge University Hospitals NHS Trust and the DH.
He is also seeking to force the Government to draw up a national policy for England on the use of DNACPR orders rather than allowing individual trusts to implement their own policies.
Many trusts use the joint statement by the British Medical Association, the Resuscitation Council (UK) and the Royal College of Nursing, Decisions relating to cardiopulmonary resuscitation, (the statement) as a starting point for local policies.
The statement makes it clear that when a clinical decision is made that cardiopulmonary resuscitation (CPR) should not be attempted because it will not be successful (and only 15-20 per cent of CPR attempts are successful) and the patient has not expressed a wish to discuss CPR, it is not necessary to discuss the patient's wishes about CPR with them. Although, careful consideration should be given as to whether or not to inform the patient of the decision, it states that in most cases they should be informed.
In our experience many patients are not informed of CPR decisions and there is debate amongst clinicians and managers about what level of communication is required with patients and in what circumstances. It is to be hoped that this case will clarify what will be required and give guidance as to whether the approach set out in the joint statement is legally correct.