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DNACPR ('do not attempt cardiopulmonary resuscitation') orders in patients with a fractured neck of femur who lack capacity.

Abstract Nationally, half of all deaths occur in hospital, with 94% having a 'do not attempt cardiopulmonary resuscitation' (DNACPR) notice in place at the time of death. Recent court rulings have raised the profile of practices surrounding DNACPR orders where patients lack capacity. Failure to consult with those close to the patient in relation to DNACPR decisions is a breach of the right to respect for private and family life under article 8 of the Human Rights Act. A report from 2016 found that those close to the patient were not consulted before one out of every five DNACPR orders are placed. We advocate addressing the issue of resuscitation in patients with a fractured neck of femur who are approaching the end of their lives. Where the patient lacks capacity, there is a legal duty to consult with those close to the patient where it is practicable and appropriate to do so. There must be a convincing and well evidenced reason to proceed without consultation, and the orthopaedic surgeon should exercise extreme caution before doing so.
PMID
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Authors

Mayor MeshTerms

Decision Making

Family

Keywords

Capacity

DNACPR

Decision

Fractured neck of femur

Legal

Journal Title annals of the royal college of surgeons of england
Publication Year Start




PMID- 28349757
OWN - NLM
STAT- MEDLINE
DA  - 20170328
DCOM- 20170417
LR  - 20170417
IS  - 1478-7083 (Electronic)
IS  - 0035-8843 (Linking)
VI  - 99
IP  - 4
DP  - 2017 Apr
TI  - DNACPR ('do not attempt cardiopulmonary resuscitation') orders in patients with a
      fractured neck of femur who lack capacity.
PG  - 255-258
LID - 10.1308/rcsann.2017.0020 [doi]
AB  - Nationally, half of all deaths occur in hospital, with 94% having a 'do not
      attempt cardiopulmonary resuscitation' (DNACPR) notice in place at the time of
      death. Recent court rulings have raised the profile of practices surrounding
      DNACPR orders where patients lack capacity. Failure to consult with those close
      to the patient in relation to DNACPR decisions is a breach of the right to
      respect for private and family life under article 8 of the Human Rights Act. A
      report from 2016 found that those close to the patient were not consulted before 
      one out of every five DNACPR orders are placed. We advocate addressing the issue 
      of resuscitation in patients with a fractured neck of femur who are approaching
      the end of their lives. Where the patient lacks capacity, there is a legal duty
      to consult with those close to the patient where it is practicable and
      appropriate to do so. There must be a convincing and well evidenced reason to
      proceed without consultation, and the orthopaedic surgeon should exercise extreme
      caution before doing so.
FAU - Hill, D S
AU  - Hill DS
AD  - University Hospitals of Morecambe Bay NHS Foundation Trust , UK.
FAU - Nazar, L
AU  - Nazar L
AD  - Hill Dickinson LLP, London , UK.
FAU - Freudmann, M
AU  - Freudmann M
AD  - University Hospitals of Morecambe Bay NHS Foundation Trust , UK.
LA  - eng
PT  - Case Reports
PT  - Journal Article
PT  - Review
PL  - England
TA  - Ann R Coll Surg Engl
JT  - Annals of the Royal College of Surgeons of England
JID - 7506860
SB  - IM
MH  - Aged, 80 and over
MH  - *Decision Making
MH  - Dementia/*complications
MH  - *Family
MH  - Femoral Neck Fractures/complications/*surgery
MH  - Humans
MH  - Male
MH  - Mental Competency/*legislation & jurisprudence
MH  - Proxy
MH  - Resuscitation Orders/*legislation & jurisprudence
MH  - United Kingdom
OTO - NOTNLM
OT  - *Capacity
OT  - *DNACPR
OT  - *Decision
OT  - *Fractured neck of femur
OT  - *Legal
EDAT- 2017/03/30 06:00
MHDA- 2017/04/18 06:00
CRDT- 2017/03/29 06:00
AID - 10.1308/rcsann.2017.0020 [doi]
PST - ppublish
SO  - Ann R Coll Surg Engl. 2017 Apr;99(4):255-258. doi: 10.1308/rcsann.2017.0020.

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