Editing Do not resuscitate (section)

=== United Kingdom ===

==== England ====
In [[England]], CPR is presumed in the event of a [[cardiac arrest]] unless a ''do not resuscitate'' order is in place. If they have capacity as defined under the [[Mental Capacity Act 2005]] the patient may decline resuscitation. Patients may also specify their wishes and/or devolve their decision-making to a proxy using an [[advance directive]], which are commonly referred to as '[[Living Wills]]', or an emergency care and treatment plan (ECTP), such as ReSPECT. Discussion between patient and doctor is integral to decisions made in advance directives and ECTPs, where resuscitation recommendations should be made within a more holistic consideration of all treatment options.<ref name="RCUK Patients" /> Patients and relatives cannot demand treatment (including CPR) which the doctor believes is futile and in this situation, it is their doctor's duty to act in their 'best interest', whether that means continuing or discontinuing treatment, using their clinical judgment. If the patient lacks capacity, relatives will often be asked for their opinion in order to form a 'best interest' view of what the individual's views would have been (prior to losing capacity). Evaluation of ReSPECT (an ECTP) found that resuscitation status remained a central component of conversations, and that there was variability in the discussion of other emergency treatments.<ref name="Eli 2020" />
[[File:Scotland DNACPR - obverse.png|thumbnail|upright=1.8|DNACPR form as used in Scotland]]

In 2020 the [[Care Quality Commission]] found that residents of [[Nursing home|care homes]] had been given inappropriate orders of Do not attempt cardiopulmonary resuscitation (DNACPR) without notice to residents or their families, causing avoidable deaths.<ref name="car-g">{{Cite news |last=Booth |first=Robert |date=2020-12-03 |title='Do not resuscitate' orders caused potentially avoidable deaths, regulator finds |language=en |url=http://www.theguardian.com/society/2020/dec/03/do-not-resuscitate-orders-caused-potentially-avoidable-deaths-regulator-finds |access-date=2021-02-15}}</ref> In 2021, the [[Mencap]] charity found that people with learning disabilities also had inappropriate DNACPR orders.<ref name="mencap-g">{{Cite news |last=Tapper |first=James |date=2021-02-13 |title=Fury at 'do not resuscitate' notices given to Covid patients with learning disabilities |language=en |work=The Guardian |url=http://www.theguardian.com/world/2021/feb/13/new-do-not-resuscitate-orders-imposed-on-covid-19-patients-with-learning-difficulties |access-date=2021-02-15}}</ref> Medical providers have said that any discussion with patients and families is not in reference to consent to resuscitation and instead should be an explanation.<ref name="Resus Council Consent.">{{cite web |title=Decisions relating to cardiopulmonary resuscitation: A joint statement from the British Medical Association, the Resuscitation Council (UK) and the Royal College of Nursing |url=http://www.resus.org.uk/pages/dnar.pdf |website=Resus.org.uk |publisher=Resuscitation Council (UK) |access-date=17 June 2014 |archive-date=19 March 2015 |archive-url=https://web.archive.org/web/20150319150953/http://resus.org.uk/pages/dnar.pdf |url-status=dead }}</ref> The UK's regulatory body for doctors, the General Medical Council, provides clear guidance on the implementation and discussion of DNACPR decisions,<ref>{{Cite web|title=Cardiopulmonary resuscitation (CPR)|url=https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/treatment-and-care-towards-the-end-of-life/cardiopulmonary-resuscitation-cpr|access-date=2021-09-15|website=www.gmc-uk.org|language=en}}</ref> and the obligation to communicate these decisions effectively was established by legal precedent in 2015.<ref>{{Cite web|title=DNACPR orders – advice and obligations|url=https://mdujournal.themdu.com:443/issue-archive/issue-5/dnacpr-orders-advice-and-obligations|access-date=2021-09-15|website=mdujournal.themdu.com|language=en}}</ref>

==== Scotland ====
In [[Scotland]], the terminology used is "Do Not Attempt Cardiopulmonary Resuscitation" or "DNACPR". There is a single policy used across all of [[NHS Scotland]]. The legal standing is similar to that in England and Wales, in that CPR is viewed as a treatment and, although there is a general presumption that CPR will be performed in the case of cardiac arrest, this is not the case if it is viewed by the treating [[clinician]] to be futile. Patients and families cannot demand CPR to be performed if it is felt to be futile (as with any medical treatment) and a DNACPR can be issued despite disagreement, although it is good practice to involve all parties in the discussion.<ref>{{cite web|title=Do Not Attempt Cardiopulmonary Resuscitation (DNACPR): Integrated Adult Policy |author=Scottish Government |publisher=NHS Scotland |date=May 2010|url=http://www.scotland.gov.uk/Resource/Doc/312784/0098903.pdf}}</ref>

As in England and Wales, inappropriate orders have been given to individuals who had no medical reason for them, such as a deaf man who received a DNACPR order in 2021 due to "communication difficulties."<ref>{{cite web|title=Deaf man given DNR order without his consent|date=4 June 2021|url=https://www.deafaction.org/news/deaf-man-given-dnr-order-without-his-consent/}}</ref>

==== Wales ====
[[Wales]] has its own national DNACPR policy, 'Sharing and Involving'.<ref>{{Cite web|title=Wales Sharing and Involving DNACPR Policy|url=https://wales.nhs.uk/DNACPR}}{{Dead link|date=February 2024 |bot=InternetArchiveBot |fix-attempted=yes }}</ref> They use the term 'Do Not Attempt Cardiopulmonary Resuscitation' or 'DNACPR'. They also have an active public information campaigns, which includes the website 'TalkCPR' <ref>{{Cite web|title=Talk CPR Videos and Resources|url=https://talkcpr.wales|url-status=live|archive-url=https://web.archive.org/web/20160120164706/http://talkcpr.wales:80/ |archive-date=2016-01-20 }}</ref>