#12 DNACPR: Case Law, headlines and facts with Ken Spearpoint

In this episode I discuss DNACPR with Ken Spearpoint. We talk about what CPR is, the cases that have been tested in court, the rulings and what we can learn from these.

Key messages from Ken

• Resuscitation is designed to reverse the reversible, not a “cure” for Ordinary Dying.

• It is important to differentiate between a sudden cardiac arrest, when the heart is the first organ to stop working and Ordinary Dying is when the heart is the last organ to stop working.

• Cardiopulmonary Resuscitation or CPR is a medical treatment, it is not an appropriate treatment for all situations. 

• CPR can have associated injury to the sternum and ribcage. 

• “Cardiopulmonary resuscitation (CPR) was introduced in the 1960s as a treatment that for some people may re-start their heart when they suffer a sudden cardiac arrest due to a heart rhythm disturbance, most commonly triggered by acute myocardial infarction (‘heart attack’) from which they would otherwise have been expected to make a good recovery.” (Decisions Relating to Cardiopulmonary resuscitation).

• In the Janet Case whilst the DNACPR decision was the correct decision, the judge ruled that Mrs Tracey’s Human Rights had been breached (under article 8) as there had been no discussion with her or her family about the decision. 

• In people who lack capacity the principle of human dignity and need for discussion with an appropriate person applies equally to someone without capacity.
  

Resource

• Resuscitation guidelines can be found through Decisions relating to cardiopulmonary resuscitation (3rd edition - 1st revision)

• Read more about the Carl Winspear case Elaine Winspear v City Hospitals Sunderland NHS Foundation Trust

• Read about DNACPR guidance updated during COVID-19 COVID-19 guidance on DNACPR & verification of death

• Read the GMC and NMC Statement on advance care planning during the COVID-19 pandemic, including DNACPR

• DNACPR decisions are never a blanket policy and each is individually made, read more: DNACPR and people with a learning disability and or autism 

• Read about the CQC review of ‘do not attempt cardiopulmonary resuscitation’ decisions during the coronavirus (COVID-19) pandemic Protect, respect, connect - decisions about living and dying well during COVID-19

• NHS guidance on DNACPR NHS Do not attempt cardiopulmonary resuscitation (DNACPR) decisions March 2021

• Read more about the Janet Tracey case Tracey v Cambridge University Hospitals NHS Foundation Trust

Find out more about my Bespoke Consultancy

• Service analysis for teams seeking to improve EoLC or prepare for CQC

• End of Life Care Education

• Lasting Power of Attorney Consultancy

• Talks and presentations

If you’d like to find out more about my work contact me.

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Thanks to all my guests for working with me to share their knowledge, experience and stories about Advance Care Planning. I hope you enjoyed listening and have insights to take away; I love hearing your reflections on the series and look forward to reviews on Spotify where you can also subscribe to the series.

Clare

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Podcast edited by Martin Whiskin.