Sensitivity on ‘do not resuscitate’ decisions is vital

Photograph: OJO Images Ltd/Alamy

The Paralympian Helene Raynsford has shone a light on the distress caused when DNR (do not resuscitate) decisions and conversations are not done appropriately (Paralympian Helene Raynsford was asked to sign ‘do not resuscitate’ form, 22 November). This is symptomatic of longstanding issues with communication around DNRs, which were exacerbated during the pandemic. To base these decisions on assumptions about someone’s disability or age is not only unacceptable, it is also unlawful. Doing so can have a catastrophic impact on people’s trust in the healthcare system, and can result in them being denied appropriate life-saving treatment.

Making assumptions based on disability or age also undermines the essential role that DNR decisions play in end-of-life care. When made and communicated properly, these decisions protect patients from invasive and often futile treatment that can do more harm than good. They can also open up important conversations about someone’s wishes for end of life.

It is a decision that many people want to make proactively – the proportion of calls that Compassion in Dying received on this issue more than doubled in 2020, with the vast majority seeking support to refuse CPR and other life-sustaining treatments should they become seriously ill.

As Helene has said, individuals must be in the driving seat of their care. DNR conversations must always involve the individual or those close to them, and be based on their circumstances and wishes. Helene’s experience should act as a warning that there is much more work to be done to ensure that this is a reality for everyone.
Usha Grieve
Director of partnerships and services, Compassion in Dying