BREAKING: Patients have been given a new legal right to be consulted before doctors place “do not attempt resuscitation” orders in their notes, the Court of Appeal has ruled.

In what is seen as a landmark case, one of the most senior judges in the judiciary said there should be “presumption in favour of patient involvement” before making the orders.

Such orders are designed to ensure patients in the final stages of their life are not subjected to unnecessary interventions by clinical staff.

“[The do not attempt resuscitation] decision is one which will potentially deprive the patient of life saving treatment,” Lord Dyson, the Master of the Rolls, said in a court ruling released today.

“There need to be convincing reasons not to involve the patient. Doctors should be wary of being too ready to exclude patients from the process on the grounds that their involvement is likely to distress them.”

Royal Courts of Justice

There ‘need to be convincing reasons’ not to involve the patient in DNR decisions, the Court of Appeal ruling said

The ruling follows a case that found that doctors at Addenbrooke’s Hospital, part of Cambridge University Hospitals Foundation Trust, had acted unlawfully when they placed a do not attempt resuscitation order in the medical records of a patient, Janet Tracey, without consulting her family.

This first notice was removed after the patient’s daughter raised an objection when she discovered it in her mother’s notes.

A second notice was put in place with the family’s agreement two days before Mrs Tracey’s death in March 2011.

Today’s court ruling is a result of a legal challenge to the first notice by the patient’s family, who were supported in the case by the Equality and Human Rights Commission.

Merry Varney, a lawyer from Leigh Day, which represented the family, said: “It is notable the court sought to underline that the duty to consult is an integral part of respecting a patient’s dignity.

“The judgment sends a clear message to all NHS trusts, regulatory bodies and healthcare professionals that patients have a legal right to be informed and consulted in relation to decisions to withhold resuscitation.”

Dr Keith McNeil, chief executive of Cambridge University Hospitals FT, 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.”

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