What to do if you disagree with a doctor’s decision on ‘do not resuscitate’

Sometimes doctors make a medical decision that if a person's breathing or heart stops, there should be no attempt to resuscitate them. It is important to understand what this decision is based on and what you can do if you disagree.

‘My grandad has dementia. His doctor says he shouldn’t be resuscitated if his heart or breathing stops, even though I’ve said he should be. Why won’t she listen to me?’

In some cases, as with your grandad, doctors may decide that there should be no attempt to resuscitate a person if they have a cardiac arrest or stop breathing. This is called a DNACPR (do not attempt cardiopulmonary resuscitation) order, often shortened to a DNR or DNAR.

This is a difficult decision, and the medical professionals involved should never take it lightly.

Why decide not to?

A decision to not resuscitate a person shouldn’t be made in a way that discriminates against them unfairly on any grounds.

The doctors should have considered the individual, their health and what is in their best interests. This is a medical decision about whether resuscitation would be successful and how much additional harm it would cause the person.

Cardiopulmonary resuscitation (CPR) is not as effective as we might believe, given how it is often portrayed on television and elsewhere.

In the few cases where CPR is successful, there can be complications such as brain damage, broken ribs and even punctured lungs. These additional problems can cause the person more pain and harm, and they might not be able to recover from them.

Whose decision?

If the doctor has decided that your grandad shouldn’t be resuscitated, she is saying that – in her medical opinion – resuscitation would not be effective or that complications would result in more pain and harm for him.

When making this decision, the doctor must consult with you and she should consider your views. However, this is a medical judgment and so it is ultimately the doctor’s decision.

This can feel unfair if you disagree with her. It is based on the idea that no one can demand medical treatment, we only have the right to refuse consent for treatment that is offered to us.

What if you disagree?

If you disagree with the decision then you should speak to the doctor, as you have the right to be consulted. You might not change her mind, but she should listen to you and explain the reasons for her decision.

If you still disagree, then you can request a second opinion. Although this isn’t an automatic right, another doctor can usually assess the situation and give their medical view.