My Survey of Hospitals in 2014 about an aspect of their DNACPR Forms

Since I joined Twitter fairly recently, I have often exchanged tweets with Kate Masters. She and I are both keen to promote the development of 'patient ownership' during end-of-life: Kate tends to use words like 'proactive' and 'reactive' [unless my memory is failing me], and I usually write 'apply our 'consent law' properly!', but we seem to want the same thing.

Kate, because of her own experience, is also very strong on what I shall term 'records which include both sides of the conversation': I share this objective, and one of my major current themes is to get lay signatures into 'clinical records'.

The aspect of DNACPR forms which I asked about in 2014, was whether their DNACPR forms allowed a Welfare Attorney whose authority extended over CPR best-interests decision-making, to sign the DNACPR form INSTEAD OF the senior clinician. The answer was invariably 'no' - and some of the justifications were, frankly, absurd. Legally, and logically, the situation seems clear: that decision is for the welfare attorney to make and express, so if it to be recorded on a form, it should be the welfare attorney who signs the form.

If 'the NHS' is not even allowing welfare attorneys to sign things which are a record of their own decisions, we have a very long way to go, before we get to where I think we need to reach - that for many things (records of conversations, some best-interests decisions) BOTH clinicians and ALSO relatives [and sometimes close friends] should be signing 'official 'clinical' records'.

But I feel sure that we do need to get to that situation - see:

http://www.bmj.com/content/352/bmj.i26/rr-5