A matter of life and death

Later this year the NHS will introduce a new form which could cause confusion and poor communication between families and medical staff.

The form will replace controversial ‘do not resuscitate’ (DNR) orders. DNRs give doctors the right, without consulting a patient or a patient’s family or carers, to let a patient die.

Unfortunately, the new emergency care and treatment plan (ECTP) may create serious problems of its own.

The ECTP is the NHS response to criticism of its DNR orders and the Liverpool Care Pathway, which has led to dying patients being deprived of food and water.

A specific high-profile case has played a crucial part in the introduction of the ECTP. Janet Tracey, who had terminal cancer, was allowed to die prematurely. Janet’s family described her as having ‘every will to live’ when a DNR was placed in her medical file. It was originally removed after complaints but later put back into Janet’s file.

There are many such cases of a DNR being incorrectly put into patient notes. The new form is meant to end to any such confusion. In part, it asks a patient’s family to choose between ‘DO resuscitate’ and ‘DO NOT resuscitate’.

We’ve read the two-page ECTP consultation form in full and find it over-complex, poorly-written and far too impersonal.

More importantly, decisions about someone’s life should surely be made during a heartfelt conversation sensitive to the patient in question. Don’t seriously ill patients deserve more than a few ticked boxes on a standardised form?

You could be forgiven for thinking that hospitals were places where patients are looked after. Once again, the public have been relegated to the status of administrative issue and treated with jargon-heavy contempt.

We don’t need 36 emotionally detached experts to ‘sort the issue out’ with yet another badly-designed form. We need clear, open, caring communication between the medical staff, the patient and the patient’s family. Without that, patients are devalued and families are denied civilised, respectful treatment.

Before the NHS introduce the form, surely a rethink is needed. We understand how hard NHS staff work and how this might save time and effort. But in this case, it’s no over-estimation to describe the situation as life or death. A badly-written and confusing multiple-choice form isn’t good enough.

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