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DNAR case prompts BMA ethical guidance reminder

Doctors are reminded that BMA advice is available to help them make difficult ethical decisions, such as DNAR (do not attempt resuscitation) orders.

The reminder comes after a law firm issued legal proceedings against an NHS trust for putting a DNAR order on the file of a man with Down’s syndrome without the knowledge of the patient’s next of kin.

Law firm Leigh Day & Co, which is pursuing the case on behalf of the patient, who cannot be named, said the order was discriminatory.

But East Kent Hospitals University NHS Foundation Trust medical director Neil Martin said the trust had ‘a clear and robust policy in place on [DNAR], which complies fully with national guidance from the professional bodies’.

BMA medical ethics committee chair Tony Calland explained: ‘If there is a sudden cardiac arrest, or even an anticipated cardiac arrest, the issue is the current clinical state of the patient.

‘If the patient is to be resuscitated, is there reasonable likelihood that the heart will restart, the breathing will restart for a reasonable period of time?’

The BMA, the Royal College of Nursing and the Resuscitation Council (UK) have produced joint guidance for healthcare staff and a model patient information leaflet.

Leigh Day & Co is also taking Cambridge University Hospitals NHS Foundation Trust and the health secretary to judicial review over DNAR policies.