Consultation before ‘do not attempt resuscitation’ orders

Do not attempt cardiopulmonary resuscitation (DNACPR) notices avoid the inappropriate use of cardiopulmonary resuscitation (CPR) in hospital and other settings. The notice applies to CPR only and does not exclude the provision of other active interventions, care and treatment by nurses. A DNACPR notice also protects nurses and other care workers from an allegation of wilful neglect under the Criminal Justice and Courts Act, section 20 (1) (R v Patel [2013])

In R(Burke) v GMC [2005], the Court of Appeal held that, once a patient is accepted by the hospital trust, nurses come under a positive duty to care for the individual. A fundamental aspect of this positive duty of care is to take such steps as are reasonable to keep the patient alive. In the case of CPR, the initial presumption would therefore be in favour of attempting resuscitation. Nurses would normally be required to instigate CPR on patients in their care who required it.