Do not attempt resuscitation decisions during the COVID-19 pandemic

A report published by the Care Quality Commission (CQC) in March 2021 found concerning variations in how ‘do not attempt cardiopulmonary resuscitation’ (DNACPR) decisions have been applied during the pandemic. The CQC found that some people and/or their relatives had not been properly involved in DNACPR decisions, or were unaware that such an important judgement about their care had been made (CQC, 2021).

End-of-life care decisions have featured prominently in the popular and professional press in recent years. For example, readers will remember the demise of the Liverpool Care Pathway (LCP), which had a primary aim of providing, high-quality and dignified care for patients approaching life's end. Although there were many supporters of the LCP, its use in clinical practice fell into disrepute after adverse newspaper headlines demonised its application when families began to complain that their relatives had been put on the LCP pathway without their consent. Furthermore, it was believed death had been hastened in some people on the pathway who were not in danger of dying imminently, through an over-prescription of powerful analgesics (Neuberger et al, 2013; Glasper, 2017).