UK doctors legally required to consult patients on DNR notices: Buddle Findlay

by NZ Lawyer30 Jun 2014
Coroner Matenga discussed the obligation to consult with, and notify a patient of, a DNR notice in the inquest into Folole Muliaga's death.  Coroner Matenga found that Muliaga's doctor decided that resuscitation was not clinically indicated, but there was no documentation to evidence that this was discussed with Muliaga or her family.  Coroner Matenga felt that even though the decision "may be totally defensible and justifiable" it was "concerning that such an important decision was made and not communicated to Muliaga nor to her family".  As noted by the Coroner, "a decision to do nothing is still a decision concerning the health and care of the patient about which the patient has the right to be informed" (Inquest findings, 19 September 2008).

Although DNR discussions can be very difficult to approach, it may help to incorporate the discussion into a general conversation about the patient's condition and prognosis.  In the event that a practitioner decides that it is not appropriate to discuss a DNR notice with a patient (and/or the patient's family), then the reasons for this should be carefully documented.  Although the UK decision is not binding in New Zealand, practitioners should be cautious about generally relying on and referencing distress as a reason to avoid a DNR discussion.  Practitioners should consider documenting in detail the reasons for their concerns, including the likely harm that may be caused to the patient.

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