Help, hospital has decided my dad is DNR but haven't told him!

mumps

j.e.j. wrote: »

This is just a general question, but doesn't a patient have to give the hospital permission to discuss their health with other people/family members?

I am not of course saying they shouldn't be talking with OP's family at a time like this, but I thought medical information is confidential, even if it's family members?

So from that regard it does sound naughty that they are not discussing something like DNR with the patient himself.

When my mother was ill in hospital we were waiting to hear results of tests, I phoned and the nurse told me the results were back. I heard her ask my mother if she wanted her to tell me the results and my mother said no. I knew what the results were then as she would have wanted me to know if it was good news but there was no way the nurse was telling me. I don't know what the rules are but I think you are entitled to confidentiality unless you are lacking capacity.

Torry_Quine

A decision on whether someone is DNR should if at all possible be discussed with the person themself or the family. I find it very wrong that something should be kept from an adult about their own care. Ultimately its a medical decision but should be done with the person and family not in isolation .

Newly_retired

When my mum was in hospital she was not able to talk and only partially aware of anything going on. When I visited DNR was discussed with me and I gave my agreement as she was not able to do so. It was the right decision.
If she had been more conscious, I'm sure she would have agreed.

pmlindyloo

Just to put another slant on this.

Recently my mother was in hospital and on our first visit we were taken into a room by the registrar and told that they would not be doing any 'invasive' procedures in the event that my mother took a 'turn for the worse'. This was before her condition was even discussed with us!

My sister and I sat there with our mouths open!

We spoke to the nurse about how shocked we were that this had been said and she apologised for the insensitive approach of the doctor.

However, she told us that it really didn't matter as the doctors had the right to decide what treatment to give in cases like this and didn't need our permission.

Thankfully my mother recovered.

It would be interesting to know if there are guidelines about this or whether it is kept 'in house'.

Gem_

I agree with the others that anyone competent should have all important decisions about their care discussed with them.

Also check whether they intend to follow the Liverpool Care Pathway with your dad. This hasens death but does do so by depriving a sedated patient of both food and fluids. Whilst it stops prolonging suffering it isn't a brilliant way to go. The hospital did this with my grandad without consulting us (and even lied about it claiming they had just removed his drip temporarily - for 6 hours to an unconscious patient) I was the only worked out what they were doing because of my own medical knowledge.

Dunroamin

purple.sarah wrote: »

This isn't a money saving question but I've found the advice on here helpful before, so here goes:

My dad is in hospital, seriously ill but stable with Emphysema and associated complications. A doctor has recently informed my mum (who is separated from my dad but still visits) that they will not move my dad to intensive care if his condition deteriorates and they will not resuscitate him if his heart or breathing stops. They have decided he is DNR but they are not going to talk to him about it in case it upsets him!

I generally agree with the decision because he has a degenerative disease and a poor quality of life, which would be worse if they brought him back with brain damage from oxygen deprivation, which they explained is a risk with resuscitation. However I disagree with the way it was handled. I think it should have been discussed with my dad, who is conscious, coherent and capable of contributing to the discussion. My mum feels he would not want to be resuscitated.

So my questions are:

Is the hospital allowed to just declare someone DNR without even discussing it with them and present it to the family as a done deal?

Should we discuss it with my dad to see what he wants and so it won't be a shock if he finds out some other way such as seeing his medical records?

Does anyone have any experience of having this sort of discussion with a loved one? How should we handle it to cause minimum distress?

My husband is in the later stages of emphysema so I'm obviously interested in the subject.

Have you clarified exactly what they mean by DNR and whether this includes putting him on a ventilator? I ask this because recent research shows that doctors in the UK are overly pessimistic about the results of this procedure and routinely deny it to patients.

http://www.medicalnewstoday.com/releases/87356.php

Edwardia

A friend of mine was being treated for cancer. After chemo she was stuck in a general ward because the oncology centre was full. She picked up an infection and there was a DNR on her which her husband and family weren't told about. She died alone aged 32.

My father was put on the Liverpool Care Pathway without consulting him, my mother or other family members. When I was told he would be dead by X day I wondered how they could know. Starting asking questions and they admitted he was on LCP.

This stuff happens all the time in UK hospitals and personally I think it's wrong.

MummyMummy_2

My nan is poorly in hospital and we was told if when having surgery she has a 'cardiac arrest' she will not be resusitated. As far as i know nobody has mentioned it to her (and why would they? If something happens it happens and shes not going to know any different is she? but we as in family were told about it) and i said well her quality of life isnt good now so shed be pretty much the same (as in a cant do anything for her self kinda state) and they said to me thats not a family decision to make, its a drs only decision to make? Not sure if thats correct but thats what i was told by a nurse looking after her? X

tired_dad

Shocked to hear some of the stories here.

My understanding is that intensive care units have models that predict the chances of successful discharge for a seriously ill patient. There are often limited ITU Beds. Therefore systems are used to select who is a candidate for ITU.

Basically the idea is that patients with no chance of meaningful survival should not be transferred to the ITU. Apart from being expensive, it is distressing for the family and patient.

Resuscitating a patient who would not be taken to ITU would be wrong.

This is a very complex situation. Sometimes things are discussed with a patient and on patient request not told to relatives. Indeed visa versa can occur. Then there are the numbers of relatives where some have a different understanding of the situation.

All I can say is each hospital has a DNR policy. It can be obtained very easily (speak to the PALS office). This will outline all the issues.

If clinically justifiable it does not always have to be discussed with patient. Usually a reason needs to be given.

meritaten

That decides it for me - I think hospitals are best avoided if you are ill/not between 0months and 60/will cost more to NHS.
my own experience has put me off hospitals and reading this thread I am horrified - I thought doctors would at least attempt to save life. instead they make 'god' decisions on who lives and who they let die - or who they actually kill by witholding food and fluids (what a horrible way to die - anyone doing that to a dog or horse would be imprisoned - and we treat humans like that and call it 'medical care'?).
my family will have strict instructions that I am not to be taken to hospital under any circumstances. If I die, at least it will be naturally - not because some jumped up git has decided I am not worth the bother!