Legal duty to consult over DNR

DOCTORS now have a legal duty to consult with patients before placing a do not resuscitate (DNR) order in medical records.

The Court of Appeal in England made the ruling in a landmark case involving Janet Tracey, a 63-year-old care home manager who died soon after fracturing her neck in a car accident. She had also recently been diagnosed and under treatment for lung cancer.

The court found that doctors at Addenbrooke’s Hospital in Cambridge had acted unlawfully in placing a DNR order without consulting her and her family. Lord Dyson ruled in his judgment that the hospital trust had violated Mrs Tracey’s right to respect for her private life under Article 8 of the European Convention of Human Rights.

He said: "Since a [DNR] decision is one which will potentially deprive the patient of life-saving treatment, there should be a presumption in favour of patient involvement.

"There need to be convincing reasons not to involve the patient."

Doctors are already advised to inform patients and their families in most cases before a DNR is applied. The ruling makes this now a legal requirement.