RCUK has put its name behind a statement produced by the national charity Compassion in Dying, about the value of DNACPR discussions and decision making.
We have joined charities, such as Marie Curie and Sue Ryder, well known GPs and broadcasters such as Dr Dawn Harper and Dr Sarah Jarvis, and clinical experts, to publicly highlight the need for improved public understanding of what DNACPR decisions are and the value they hold to many people.
While we acknowledge, and are saddened by, examples of poor practice in relation to DNACPR decision-making during the pandemic, we also recognise not everyone wants cardiopulmonary resuscitation (CPR) to be attempted. For many people, DNACPR decisions offer reassurance that they will not be given an intervention that may be unwanted or unsuccessful.
The joint statement makes clear that DNACPR decision making must always involve the person, or those close to them, and should be part of a wider conversation about what matters to that individual. We wholeheartedly support this stance.
That’s why RCUK has been working hard over recent years to develop the ReSPECT (Recommended Summary Plan for Emergency Care and Treatment) process and encourage its adoption across the UK. The ReSPECT process supports broader conversations taking place with a person, their legal proxy or family about what matters to the person and enables person-centred decision-making to take place. It guides people to have conversations with healthcare professionals in advance to plan for emergency care and treatment, including whether CPR should be attempted.
The ReSPECT process helps to develop a shared understanding between the healthcare professional and a person about their condition, the outcomes the person values and those they fear and then how treatments and interventions, such as cardiopulmonary resuscitation (CPR) fit into this. As such it can provide reassurance that recommendations around whether CPR should be attempted are made in the context of what’s important to the person concerned.
The ReSPECT process is widely used by health and social care organisations across England and in some parts of Scotland. To find out more, visit: www.resus.org.uk/respect