DNR notice violated woman’s human rights

The widower of a terminally ill hospital patient has won a landmark ruling that her human rights were violated because she was not consulted before a "do not resuscitate" notice was placed on her records.

DNR notice violated woman’s human rights

The Court of Appeal was asked to intervene by David Tracey, who said his wife Janet, aged 63, was subjected to an unlawful DNR notice at Addenbrooke’s Hospital, Cambridge.

Such notices are intended to ensure that a patient dies in a dignified and peaceful manner, but they have become the subject of controversy.

The government and health chiefs were accused in court of failing to tackle widespread confusion and uncertainty over the imposition of notices on seriously ill patients.

Ms Tracey, a care home manager, died following a transfer to Addenbrooke’s after breaking her neck in a car crash on February 19, 2011 — two weeks after being diagnosed with terminal lung cancer.

Lord Dyson, master of the Rolls, who sat with Lord Justice Longmore and Lord Justice Ryder, said the hospital trust violated Ms Tracey’s right to respect for her private life under Article 8 of the European Convention of Human Rights because it did not involve her before issuing the original DNR notice on February 27, 2011.

The judges unanimously agreed patients should be “consulted and involved in the decision-making process” — unless a clinician considers consultation is likely to cause the patient physical or psychological harm. They cautioned against not involving patients just because they were distressed.

However, the judges rejected complaints that the health secretary infringed Ms Tracey’s rights in her last days by failing to promulgate appropriate national guidance on DNR notices.

Lord Dyson described how one of Ms Tracey’s daughters, Alison Noeland, was “horrified” and registered her objections when she discovered the first notice had been issued, and it was removed and cancelled on March 2, 2011.

Three days later it was agreed with members of the family that a second notice should be placed on Ms Tracey’s notes. She died soon after on March 7.

A spokesman for Cambridge University Hospitals NHS Foundation Trust said: “The trust is considering the implications of this judgement and the next steps very carefully.

Chief executive Dr Keith McNeil said: “Today’s ruling hinges on a specific point of law. There was no criticism of our clinical care. It is a fact of life that every day people die in hospitals. From my own experience as a specialist hospital doctor, the most important thing is that these patients are treated with the utmost respect and dignity.

“End-of-life situations involve doctors and nurses having emotionally challenging but necessary conversations with patients and their families about what happens in the final stages of their care.

“Medical staff use a combination of their compassion, experience, and judgement at these difficult times to try and find the right pathway for each individual patient, and provide the support needed for everybody involved.”

An emotional Mr Tracey, 66, said the ruling was “a good result”.

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