Abstract/Summary

Evidence has shown a diversity of practices and terminology concerning the implementation and documentation of Do Not Attempt Cardio-Pulmonary Resuscitation (DNACPR) notices across different hospital Trusts in England and Wales, and the Resuscitation Council (UK) has recently proposed a standard approach for how DNACPR notices can be better incorporated into overall care plans. However, the Council can only make recommendations for good practice. This discussion reviews current practices and suggests that the time has come for a national standardized approach to the process of initiating and documenting DNACPR, along with a dedicated programme to increase public understanding of what is involved. A national policy framework for DNACPR notices would avoid regional and institutional differences, bust current myths, and ensure communication with, and involvement of, the patient remains at the heart of medical practice and decision-making. Importantly, it would both ensure that the respective legal rights and obligations of patients and professionals are respected, as well as providing clear public health benefits. At the very least, a national conversation would help achieve common understandings and expectations.