CPR stands for cardiopulmonary resuscitation. It is a treatment that can be given when you stop breathing (respiratory arrest), or your heart stops beating, (cardiac arrest). CPR tries to get your breathing and heart going again.
DNACPR stands for do not attempt cardiopulmonary resuscitation. DNACPR is sometimes called DNAR, (do not attempt resuscitation), or DNR (do not resuscitate), but they all refer to the same thing. DNACPR means if your heart or breathing stops, your healthcare team will not try to restart it. A DNACPR decision should be made by you and/or your doctor or healthcare team.
“DNACPR is about CPR only. It does not mean that you will not get care and treatment. You will continue to have all the other appropriate care, treatment and support you need.” Source NHS here
In October 2020, the Department of Health and Social Care (DHSC) asked the Care Quality Commission (CQC) to review how DNRs were used during the COVID-19 pandemic, building on concerns that were reported earlier in the year. The final report from the CQC can be found here
In our opinion, this report misses a crucial area. It does not seem to address the fact that over the last year there has been a widespread disconnect in the medical profession, about what a DNR actually means, and how doctors have treated a patient who has a DNR.
Remember, a DNR means only that your heart and/or breathing should not be restarted if they stop. It DOES NOT mean that your medical treatment should be withdrawn. Neither does it mean you should be placed on nil by mouth or refused hospital admission.
In our opinion, the CQC report does not address the following issues:
- People, especially those in care, being refused admission to hospital for treatment of any illness, because a DNR had been placed on their medical records, some placed without their knowledge
- People in care homes, hospices and hospitals, being placed on end-of-life pathways because they had a DNR on their records, again some having been placed there without the patients knowledge, or the knowledge of their family
- Why so many in the medical profession have demonstrated during the last year that a DNR is a green light for them to place a person onto nil by mouth, and use midazolam and morphine as a pathway to end that person’s life