Doctors Wrong On 'Do Not Resuscitate' Notice

Doctors should not have put a "do not resuscitate" notice on a woman patient without her consent, the Court of Appeal has ruled.

Janet Tracey, who had terminal lung cancer, had a "do not resuscitate" notice put on her records, but neither she nor her family had been notified about the decision by medics.

Judges said doctors at Addenbrooke's Hospital in Cambridge, where Mrs Tracey died, should have discussed the notice with the 63-year-old or her family and the fact they had not been notified was a violation of her human rights.

Mrs Tracey's husband David, who brought the case, said it had been a "good result" and he hoped it would help other families in similar situations.

He said: "Patient care has got to come first and this will bring more care to people."

The ruling is seen as a key decision because it gives clarity on when - and in what circumstances - doctors should issue "do not resuscitate" notices.

The notices are widely used, and the court heard that 68% of people die in hospital and of those 80% have "do not resuscitate" notices in their medical notes.

They are designed to ensure patients die a dignified death, however, their use has become controversial and the rules surrounding them have been criticised for being confusing.

The notice was put in Mrs Tracey's medical notes when she was taken to hospital after breaking her neck in a serious car crash two weeks after being diagnosed with cancer.

Her family were not informed and when they discovered the existence of the notice they complained and it was cancelled.

However, after discussions with doctors a second notice was put in place with the family's agreement and Mrs Tracey died two days later on March 7, 2011.

Merry Varney from law firm Leigh Day, who acted for the Tracey family, said: "Janet, a care home manager, would have been horrified if one of her residents had been treated in this way and she would have fought, as her husband has, to ensure that patients have a legal right to be informed and consulted in relation to decisions to withhold resuscitation."

A spokesman for the Cambridge University Hospital NHS Foundation Trust said it was considering the implications of the judgement and stressed there had been no criticism of the clinical care provided.

The trust's chief executive, Dr Keith McNeil said: "End-of-life situations involve doctors and nurses having emotionally challenging but necessary conversations with patients and their families about what happens in the final stages of their care.

"Medical staff use a combination of their compassion, experience and judgement at these difficult times to try and find the right pathway for each individual patient, and provide the support needed for everybody involved."