Doctor gave cancer patient Do Not Resuscitate order

The Northern Echo: SOUGHT LEGAL ADVICE: Alan Cargill, who was told he would not be resuscitated if anything happened to him during a stay at the North Durham hospital SOUGHT LEGAL ADVICE: Alan Cargill, who was told he would not be resuscitated if anything happened to him during a stay at the North Durham hospital

A CANCER patient has spoken of his "terror" when a hospital doctor issued him with a Do Not Resuscitate order.

Alan Cargill, 69, from West Cornforth, County Durham, was being treated at the University Hospital of North Durham, in Durham City, when he was approached by a doctor.

"I had reacted badly to chemotherapy and I also had a blood clot so they admitted me to hospital," said Mr Cargill, who has been diagnosed with cancer of the inner chest wall.

"This doctor came to see me and informed me that I wouldn't be brought around again if anything happened. I would just be left."

Mr Cargill said the doctor gave him a form prominently marked Do Not Resuscitate and walked away.

The former haulage boss said the experience frightened him.

"He terrified me, to be truthful. It is bad craic for something like that to happen when you are that ill.

"It is stamped all over with Do Not Resuscitate. Apparently, you are supposed to carry it round with you."

Mr Cargill was also concerned that the matter was raised with him without any other member of his family being present.

A few days later Mr Cargill was discharged and allowed home where he discussed the Do Not Resuscitate order with his family.

He was so concerned that Mr Cargill decided to raise the matter with his solicitor.

"I talked to my solicitor and asked him, could they do that? He told me they can't."

After taking legal advice Mr Cargill contacted the hospital, confirmed that he did not wish the order to apply to him and then tore up the document.

Despite the shock of being issued with a Do Not Resuscitate order, Mr Cargill has nothing but praise for hospital staff.

"I have no complaints about the medical care. It couldn't have been better."

The widowed grandfather, who has two grown-up daughters, has decided not to have any more treatment for his cancer for the time being.

But last night he joked: "I have every intention of living as long as possible. I have just bought a new car!"

Do Not Resuscitate, or DNR orders are increasingly being used in the NHS when it is thought that the benefits of resuscitation are outweighed by the negative effects. The presence of a DNR order on a patients file means that medical staff are not required to resuscitate a patient if their heart stops or if they stop breathing.

Katherine Murphy, Chief Executive of The Patients Association, said: "The use of DNR orders is understandably a sensitive and deeply distressing issue.

"Sadly, there have been far too many cases where healthcare professionals have failed to facilitate proper conversations with relatives and patients about how, when and why a DNR order may be used.

"Hospitals need to look carefully at their procedures to ensure there are open discussions around end of life care involving both patients and relatives."

Guidelines from the British Medical Association state that DNR orders should only be issued after discussion with patients or their family.

Last week The Northern Echo highlighted the fact that hospitals in the region have received more than £2m for using a controversial "end-of-life" programme which allows doctors to withdraw treatment and fluids.

Officials say the plan - called the Liverpool Care Pathway - is a compassionate method of treating dying patients.

But the Government has ordered a review of its use after claims that some families had no idea their relatives were on it.

A spokesman for County Durham and Darlington NHS Foundation Trust said: "We are sorry to hear about this complaint, and would welcome contact via the Patient Advice and Liaison Service (PALs), and the opportunity to meet with the complainant to discuss their concerns.

"Resuscitation decision making is a complex process. County Durham and Darlington NHS Foundation Trust has a comprehensive policy that describes the process that we expect staff to follow when supporting patients and their families during this difficult time. This policy is based upon regional best practice."

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Comments (9)

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7:09am Tue 12 Feb 13

jandarlo says...

Its disgusting how hospitals treat those that they deem not worthy of rescusitation! Its legalised euthanasia of an aging and/or sick population.
Its disgusting how hospitals treat those that they deem not worthy of rescusitation! Its legalised euthanasia of an aging and/or sick population. jandarlo
  • Score: 1

9:04am Tue 12 Feb 13

oliviaden6 says...

It is OUTRAGOUS everyone should be given the chance of life where atall possible the NHS and its Managers are only thinking of the bottom line. This was made evident a week or two agao when a article stated that the NHS in the North East hadf received 2 million from central funds under the Liverpool Path way scheme quiet frankly its disgusting. This way forward needs to be STOPPED in its own pathway NOW?
It is OUTRAGOUS everyone should be given the chance of life where atall possible the NHS and its Managers are only thinking of the bottom line. This was made evident a week or two agao when a article stated that the NHS in the North East hadf received 2 million from central funds under the Liverpool Path way scheme quiet frankly its disgusting. This way forward needs to be STOPPED in its own pathway NOW? oliviaden6
  • Score: 1

11:00am Tue 12 Feb 13

Cycling Scientist says...

That is really shocking. Of course there are patients who opt to be rather left dying instead of having a no-quality life prolonged by machines, but this decision must be up to the patient and not the doctor ! It is incredible how some doctors think they do the decisions patients should do. This brings memories up to my NHS dentist who never gave me options - I changed in the mean time. About Durham hospital, I have mixed experiences. Most times I was treated well, but once I got shouted at for telling the lady that did the ECG that one of the electrodes she attached has fallen off - not very professional.

I wonder if the introduction of a "patients will" would help here ? In Germany you can do this ("Patiententestament
"), so you have the decision what to do if you end up on life support machinery written down: Rescuitate me or do not do it.
That is really shocking. Of course there are patients who opt to be rather left dying instead of having a no-quality life prolonged by machines, but this decision must be up to the patient and not the doctor ! It is incredible how some doctors think they do the decisions patients should do. This brings memories up to my NHS dentist who never gave me options - I changed in the mean time. About Durham hospital, I have mixed experiences. Most times I was treated well, but once I got shouted at for telling the lady that did the ECG that one of the electrodes she attached has fallen off - not very professional. I wonder if the introduction of a "patients will" would help here ? In Germany you can do this ("Patiententestament "), so you have the decision what to do if you end up on life support machinery written down: Rescuitate me or do not do it. Cycling Scientist
  • Score: 1

11:03am Tue 12 Feb 13

Idontknowaboutyoubut says...

There used to be what was referred to as a "Red Dot" system in Hospitals.That indicated the patient would not be resuscitated.I dont think the next of kin were informed,or even aware of the implication of the red dot on patient notes.
I suppose there is more openness now,but there should be an informed discussion between next of kin and medics.The medic in the article sounds extremely insensitive,to say the least...
There used to be what was referred to as a "Red Dot" system in Hospitals.That indicated the patient would not be resuscitated.I dont think the next of kin were informed,or even aware of the implication of the red dot on patient notes. I suppose there is more openness now,but there should be an informed discussion between next of kin and medics.The medic in the article sounds extremely insensitive,to say the least... Idontknowaboutyoubut
  • Score: 1

11:54am Tue 12 Feb 13

Homshaw1 says...

Is this even legal?

Withdrawing help in this way with no discussion with people affected is questionable
Is this even legal? Withdrawing help in this way with no discussion with people affected is questionable Homshaw1
  • Score: 1

12:46pm Tue 12 Feb 13

justsayingso says...

DNR note on a Patients Records was around in the 80's when I was at DMH
DNR note on a Patients Records was around in the 80's when I was at DMH justsayingso
  • Score: 1

12:47pm Tue 12 Feb 13

justsayingso says...

I also think its used throughout the NHS but in my view , unless specifically requested by the patient, its fundamentally wrong.
I also think its used throughout the NHS but in my view , unless specifically requested by the patient, its fundamentally wrong. justsayingso
  • Score: 0

1:14pm Tue 12 Feb 13

IanfromCrook says...

Cycling Scientist wrote:
That is really shocking. Of course there are patients who opt to be rather left dying instead of having a no-quality life prolonged by machines, but this decision must be up to the patient and not the doctor ! It is incredible how some doctors think they do the decisions patients should do. This brings memories up to my NHS dentist who never gave me options - I changed in the mean time. About Durham hospital, I have mixed experiences. Most times I was treated well, but once I got shouted at for telling the lady that did the ECG that one of the electrodes she attached has fallen off - not very professional.

I wonder if the introduction of a "patients will" would help here ? In Germany you can do this ("Patiententestament

"), so you have the decision what to do if you end up on life support machinery written down: Rescuitate me or do not do it.
It would not work I am afraid, my mother through a nursing home had a document indicating that she would like everything possible done. Family were of the same opinion. Doctors did not.......signed document......useles
s.
I was also told as my mother had been diagnosed with a neurological disease we had no rights at all, I was also told that if I had full power of attorney it would make no difference. I was in the process of getting this but it took months and came a week after mum died.
Some doctors use the poor management system to measure standard of life to their personal beliefs.
Doctor told me no use in operating as little chance of success, when I pointed out that doing nothing meant no chance of success changed his wording to no chance.
Staff nurse told me not to feed my dying mother because it may kill her.

I believe most staff do their best and care in a professional manor.
However it should be up to the patient/family to make decisions about withdrawing treatment. It is like euthanasia via the back door something that the medical profession says they are against.
[quote][p][bold]Cycling Scientist[/bold] wrote: That is really shocking. Of course there are patients who opt to be rather left dying instead of having a no-quality life prolonged by machines, but this decision must be up to the patient and not the doctor ! It is incredible how some doctors think they do the decisions patients should do. This brings memories up to my NHS dentist who never gave me options - I changed in the mean time. About Durham hospital, I have mixed experiences. Most times I was treated well, but once I got shouted at for telling the lady that did the ECG that one of the electrodes she attached has fallen off - not very professional. I wonder if the introduction of a "patients will" would help here ? In Germany you can do this ("Patiententestament "), so you have the decision what to do if you end up on life support machinery written down: Rescuitate me or do not do it.[/p][/quote]It would not work I am afraid, my mother through a nursing home had a document indicating that she would like everything possible done. Family were of the same opinion. Doctors did not.......signed document......useles s. I was also told as my mother had been diagnosed with a neurological disease we had no rights at all, I was also told that if I had full power of attorney it would make no difference. I was in the process of getting this but it took months and came a week after mum died. Some doctors use the poor management system to measure standard of life to their personal beliefs. Doctor told me no use in operating as little chance of success, when I pointed out that doing nothing meant no chance of success changed his wording to no chance. Staff nurse told me not to feed my dying mother because it may kill her. I believe most staff do their best and care in a professional manor. However it should be up to the patient/family to make decisions about withdrawing treatment. It is like euthanasia via the back door something that the medical profession says they are against. IanfromCrook
  • Score: 1

4:22pm Tue 12 Feb 13

Hosiptal Visitor says...

From personal experience of two local hospitals, a consultant at the first added a DNAR notice to a close relatives notes without even speaking to family, who were present daily. Worse still, it was signed, dated and marked as permanent when the person was declared fit to discharge home!!

Second occasion, same relative/different hospital, family were involved from day one with decisions involving dnar/end of life plan, and everything was explained carefully and compassionately by the staff involved. What a difference to the first consultant who decided we weren't important enough to be involved.
From personal experience of two local hospitals, a consultant at the first added a DNAR notice to a close relatives notes without even speaking to family, who were present daily. Worse still, it was signed, dated and marked as permanent when the person was declared fit to discharge home!! Second occasion, same relative/different hospital, family were involved from day one with decisions involving dnar/end of life plan, and everything was explained carefully and compassionately by the staff involved. What a difference to the first consultant who decided we weren't important enough to be involved. Hosiptal Visitor
  • Score: 0

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