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Lawyer calls for consistency on DNR orders

Lawyer Merry Varney has said that the case of ‘L' in the High Court, is further evidence of a need for a NHS-wide policy on DNR orders.

21 August 2012

Leading ‘Do Not Resuscitate’ lawyer Merry Varney has said that the case of ‘L” a Muslim man in a persistent vegetative state currently being fought in the High Court, is further evidence of a need for a NHS-wide policy on DNR orders to protect patients and clinicians by introducing clarity and consistency into the circumstances under which these orders should be put in place.

The family of the the severely brain-damaged 55-year-old known only as ‘L’, is fighting for him to receive life-saving treatment, if his condition deteriorates, against medical advice. They have argued that if could express his wishes he would never agree, because of his faith, to a Do Not Resuscitate order.

Pennine Acute Hospitals NHS Trust, which is responsible for his care, is seeking a court declaration that it would not be in his best interests to offer him ventilation or resuscitation if there was "a life-threatening event".

Claire Watson, appearing for the Trust, said it was the unanimous view of clinicians treating L, as well as independent experts, that the family man was in a persistent vegetative state, following several heart attacks, "with minimal prospects of improving any neurological function and no meaningful prospect of further recovery".

The hearing is in the Court of Protection, as ‘L’ is a vulnerable adult whose condition means he lacks the capacity to make decisions about his medical treatment. It has been told it was the family's view that "life is sacred and it would be contrary to the tenets of their religion not to provide life supporting treatment".

Lawyers for the family have told the judge that, days after L suffered a cardiac arrest, a DNR notice was placed in his notes without consulting them in contravention of the Trust's own policy. They say that when the family learned, they objected and the DNR notice was taken out of the notes.

The Pennine NHS Trust argues that treatment should now be limited to what doctors consider is reasonable to maintain his dignity and to relieve any pain and discomfort he may be feeling - but it would not be in his best interests for active resuscitation or ventilation to be provided in the event of another cardiac arrest or other deterioration of his condition.

Merry Varney from the Human Rights team at Leigh Day & Co said: “Yet again this is an instance of a loved one being given a DNR order without first telling the family, one wonders whether the Trust would have told the patient had his condition been different and he had been conscious, time after time we have seen DNR orders being put on peoples records without either the family or the patient being aware.

“It is clear that across the NHS there needs to be clear guidance as to when and how these orders are placed on peoples records. They are a measure to prevent potentially life saving treatment and therefore the position as to when they can be used, the information to be given to patients and families in advance and the process if there is a disagreement needs to be absolutely clear.”

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