The rights of patients in the UK today are horrifyingly
limited but at least the court recognised here that they should be consulted
when their medical team presumes to take life or death decisions on their
future healthcare.
Although, it could, and has, give rise to endless debate,
the merits of whether or not to undertake CPR (cardio-pulmonary resuscitation) was not the main issue in this
case. The crux of the judgment is that Mrs Janet Tracey, who although very sick
(she was badly injured in a car crash and had been diagnosed with a terminal
brain tumour), was fully aware and cognisant was not consulted or involved in
the decision making process when a Do Not Resuscitate (DNR) order was placed in
her file by her doctors. And, by the way, neither was any other member of her
close family who were almost constantly at her bedside.
Doctors in the UK are treated like minor deities. They are a
scarce resource, if not always well paid. Most of them, I know from personal
experience, are approachable, humane and decent, some, however are arrogant and
overbearing and not a few are woefully ignorant about ethics and the rights of
those in their care. Needless to say the courts almost always bend over
backwards to accommodate them. But in this case judge recognised that they may
have gone too far:
There is nothing in the medical/nursing records which suggests any agreement to DNACPR by Mrs Tracey... If Dr L. had such a conversation, it would have been of importance to note the same both on the DNACPR Notice and in the medical records. I am unable to accept that the absence of such a note is a result of no more than poor record keeping.(emphasis mine)
And, even more damningly:
I am unable to accept Dr L’s evidence that he spoke to Mrs Tracey about resuscitation prior to the implementation of the first DNACPR Notice.
So god 0, patient 1, then; perhaps this is a good beginning, the recognition that a doctor does not have the right to unilaterally take a decision on the patient's behalf if the patient or their family are capable, they must and should be involved in the decision making process.
Don't get me wrong, It is completely understandable that many people would
rather delegate full decision making responsibility to their medical team, that
is their choice. However, not all of us feel the same, and it
should never be forgotten that in any civilized society the patient's decision
as to their level of involvement must always be respected.
In my view, further progress needs to be made we should be moving towards a position where the doctor needs to obtain the patient's consent to make such a decision in the first place, hopefully, Mrs Tracey's case is a first step in that direction.
