Commenting on the publication of the CQC’s report Protect, Respect, Connect – decisions about living and dying well with Covid-19, John Chisholm, chair of the BMA’s medical ethics committee, said: “The BMA released joint guidance with the Care Quality Commission, the Care Provider Alliance and the Royal College of GPs at the very beginning of the pandemic. That guidance supported and reaffirmed existing guidelines on best practice for advance care planning and the sensitive discussions that are required in order to encourage people to think about what they would want to happen if they should suffer a cardiac or respiratory arrest.
“It is imperative that discussions with individuals and families about cardiopulmonary resuscitation – or CPR – should be personal and individual so that care plans can be properly formulated. If the patient does not have capacity to make these decisions, then this discussion should be held with people’s families or other appropriate individuals to help determine what would be in their best interests. There should never be a ‘blanket’ policy applied at any level as every person is an individual and should be treated as such.
“In the report, the CQC found some DNACPR notices that did not meet these standards and which may have caused avoidable deaths. This is of course a tragedy and unacceptable. We hope that the publication of this report begins to challenge any local level issues which have occurred, and that swift action is taken to ensure consistently high standards of practice. Discussions about whether or not patients would want CPR to be attempted should be one part of individualised advance care planning, and be open to scrutiny and happen with proper oversight as today’s report suggests. DNACPR decisions should never be made on the basis of a blanket approach applied to all."
Notes to editors
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- For a copy of the report and press release contact the Care Quality Commission
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