Expert: Patients should make views known on resuscitation

Patients who do not want to be resuscitated should make their views clear before a life-threatening illness strikes, in order to help prevent stand-offs between families and medics, a leading doctor has said.

Speaking before a conference on the issue last night, Dr Patrick Plunkett, clinical professor of emergency medicine at Trinity College Dublin, said the controversial step would ensure the protection of peoples wishes.

While there is still no legal framework to support the issue in Ireland, a draft HSE document outlining ways the potential step could be introduced is currently open to submissions from the public.

Dr Plunkett said that, although some may be opposed to allowing someone to die when they could be kept alive, it was his experience that in many cases, a “do not attempt to resuscitate” policy is the best approach.

“We’re talking about when somebody’s heart stops or they stop breathing. There seems to be an assumption that we will keep you from dying forever. But when somebody naturally dies, that’s when it should be considered,” said the senior expert, who is also a clinical director at St James’s Hospital.

According to Dr Plunkett, “less than 10%” of elderly people who are resuscitated — or brought back to life by medics — go on to have what they would see as useful lives.

As such, he said in many cases it was in the person’s best interests to pass away peacefully in the way they chose rather than extending a life past its natural conclusion.

“This is not forcing things on people. We’ll [doctors] do whatever’s reasonable [to keep someone alive]. But it is equally not about forcing us to do something we believe as doctors is wrong,” he told RTÉ radio’s Today With Pat Kenny.

Speaking on the same programme, medical ethics expert, senior law lecturer at UCC and chair of the national consent advisory group, Dr Deirdre Madden, was unsure whether a legal framework was needed for such a protocol to be introduced.

However, she stressed that patients, doctors and families facing circumstances involving controversial end-of-life choices should consider the person’s illness, their prognosis and life expectancy if they recover before any decision is made.

“It should be discussed in advance [of the illness],” she said.

* The draft HSE document on whether a “do not resuscitate” protocol should be introduced is currently open to public submissions, and can be found at www.hse.ie