Has anyone else had the forced DNA conversation with their doctor?

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My husband has terminal cancer and is in hospital on an antibiotic drip.  The registrar asked him to sign a DNACPR today.  I was there in the room and fortunately had discussed pushing on with treatments earlier so we’re both in agreement to not sign.  The registrar then says he has the final say and as a terminal patient my husband will not be resusicated if he has a heart attack in the hospital.

my concern is why bother to ask?  Apparently the outcomes for cancer patients regarding cpr intervention are not good.  The dnr was presented as a treatment so in the event of a cpr emergency the treatment option would be to do nothing and allow nature to take its course.  Seemingly since 2020 anyone who has a frailty index number above 5 does not get resusicated. Terminal cancer is frailty index of 9 - a 5 would be disabilities etc.  


I found all this alarming.  There are studies out that show anyone with a dnr is last in the queue for scans, surgery and the rest and has worse outcomes than non dnr patients.  Now it seems a dnrcpr is at the discretion of your doctor according to a check list of frailty devised by doctors.

the most disturbing argument presented was that administering cpr to a frail patient was very disturbing emotionally to the medical team.  You couldn’t make that one up.  As if it is the patients job to spare the medics by dying nicely.  Madness.

has anyone else had this happen to them or their nearest and dearest?  My husband has terminal cancer and an infection but is not frail yet.  Able to walk 30 minutes daily, wash and dress himself not sleeping all day so is not end stage yet.

imagine a forced dnrcpr if you were only a 5 on the frailty index.  The registrar took about 7 minutes to talk about treatment and 15 to tell us he had the legal right to deny cpr and was going to exercise it.  After 12 minutes I suggested that such a decision surely required more than one doctors opinion and we were informed that a second opinion could be sought.  All this with no warning or explanatory leaflet and this doctor was on the oncology team.  

if my husband was lying in bed without much chance of any kind of recovery I could understand but at this point a ct scan hasn’t even been done to plot the rate of growth of his inoperable tumour.

JaneyC 

  • I had this conversation over the telephone while mum was in hospital in December, having caught covid while in hospital for septic arthritis.  Just like with your husband, they said mum was too frail to be put through CPR even though she had said she wanted it.  I asked if we could request CPR on her behalf, and the consultant said it was their decision to make on medical grounds as and when it happened.  Like you I wondered why they'd bothered asking mum and then me.  

  • My husband was admitted to our local hospital in April due to an infection. I stayed with him in A&E and within an hour I was approached 3 times to discuss DNAR despite my clear distress and me saying I did not want to have the conversation.  I told them not to discuss it with my husband who was very confused.  They went against my wishes and claimed he had agreed to DNAR.  When I talked to him about this he asked me what DNAR meant and said he had no recollection of being asked and would never have agreed to it!! He said it made him feel like his life wasn't important. He is still fighting because his life is important!  

  • How appalling Kikid - I genuinely think there were times when the elderly and terminally ill were just expected to step aside and tidily get their dying over with without any fuss because the health service was so overwhelmed.  Triage is a thing but we all kind of thought it was basically fair.  

    At the time mum appeared to have lost her mind and memories, and was desperately ill, so I do understand why they would prioritise use of machines to keep younger people alive.  But mum has proved everyone wrong by getting her marbles and her memories back, and is now having a decent quality of life, albeit probably very limited now.  She deserved that chance, I think. 

  • Bit of an update

    so a second opinion entered the fray to apologise at how my husband and I were blindsided by the registrar regarding dnr authority.  A future outpatient appointment will readdress this issue where we will both be present.  Good result.

    however, I just happened to be visiting today when a nurse exercised her right and directive from the consultant to try and explain the respect form which has now been presented to my husband twice in 24 hours.  

    i suspect  there has been a directive to clear the expendables to ensure enough icu beds are available for the expected winter surge of Covid cases on icu..  I asked the nurse to stop and leave.  She wouldn’t - she said she had to do as ordered. I said we refused this traeatment option and she said my husband had to say it and he did but she ignored him,  so far circa 30 minutes from3 professionals on getting a dnr signed all harassing.  What is going on?

    Janeyc

  • Wow JaneyC what a horrible experience.  I had a phone call from the Trust saying that they had investigated mum catching Covid in hospital and concluded it was the hospital's fault, and they'd send a letter of apology.  It never arrived.  I don't think I have the heart to chase it up.

    I'm absolutely sure mum was expected to die, and most of the health care professionals I spoke to (precious few really) made little attempt to hide their expectation.  I was left in no doubt at all they sent her home to die and I'm so proud of her for proving them wrong.  There were some golden staff of course, but some dreadfully unprofessional behaviour happened and there was a good deal of shifty back-covering when I asked for an explanation of one particular incident with mum where it seemed to me that she'd been treated with absolute disrespect.