In a concerning revelation, a parliamentary watchdog has found that doctors issued "do not resuscitate" (DNAR) orders for elderly and disabled patients during the COVID-19 pandemic without the knowledge or consent of their families. This breach of human rights, outlined in a new report by the Parliamentary Health Service Ombudsman (PHSO) in collaboration with the charity Dignity in Dying, sheds light on significant failings in end-of-life care conversations, particularly regarding vulnerable populations.

 

The report highlights at least 13 cases where patients and their families were not informed about the issuance of DNAR orders, infringing upon their fundamental rights. It calls attention to the unacceptable nature of these failures and emphasizes the need for improvement in how healthcare professionals approach discussions about death and end-of-life care, especially with elderly and disabled patients.

 

During the pandemic, concerns arose over the inappropriate application of DNAR orders, particularly affecting elderly individuals and patients with learning disabilities. The NHS's annual Learning Disability Deaths Review for 2021 revealed that DNAR orders were not correctly followed in 60 percent of deaths in 2020, with "learning disability" cited as a reason for withholding resuscitation in some cases.

 

One poignant example highlighted in the report is the case of Sonia Deleon, a 58-year-old woman with schizophrenia and learning disabilities who was wrongly issued a DNAR order during her hospitalization for COVID-19. Despite her family's unawareness, multiple DNAR notices were placed in Sonia's file, listing reasons such as frailty, learning disabilities, schizophrenia, and dependency for daily activities. Sonia's sister, Sally-Rose Cyrille, expressed devastation and anger upon discovering this information, emphasizing the profound impact on their family.

 

Key findings from the PHSO and Dignity in Dying underscore the urgent need for improvement in end-of-life care conversations. These include the observation that discussions about resuscitation often occur too late, particularly in emergency situations, and that healthcare professionals fail to provide accessible information to patients and their families. There is also a lack of public awareness about cardiopulmonary resuscitation (CPR) and decision-making responsibilities.

 

Health Ombudsman Rob Behrens stressed the importance of normalizing conversations about end-of-life care and ensuring that individuals are treated with respect and dignity regardless of age or disability. He emphasized that failing to engage in these discussions constitutes maladministration and a breach of human rights, calling for urgent improvements within the NHS.

 

Usha Grieve, Director of Partnerships and Services at Compassion in Dying, echoed Behrens' sentiments, emphasizing the harm caused by poor communication and the erosion of trust between patients and healthcare professionals. She stressed the need for systemic change to address longstanding communication failures and ensure that individuals receive compassionate and dignified care.

 

15.03.24

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Forced attrition....

To experience 'the erosion of trust between patients and healthcare professionals' one only needs to be so unfortunate as to be admitted to a hospital where imposed Protocol is strictly adhered to and patients treated as numbers or underage children.

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