Coronavirus: Unlawful do not resuscitate orders imposed on people with learning disabilities

‘Decisions on people’s treatment that are based on someone having a learning disability are never OK – even one is too many’

Unlawful ‘do not resuscitate’ orders are being placed on patients with a learning disability during the coronavirus pandemic without families being consulted.


National charities have successfully challenged more than a dozen unlawful do not resuscitate orders (DNRs) that were put in place because of the patient’s disability rather than due to any serious underlying health risk.

Turning Point said it had learned of 19 inappropriate DNRs from families while Learning Disability England said almost one-fifth of its members had reported DNRs placed in people’s medical records without consultation during March and April.

In one example, a man in his fifties with sight loss was admitted to hospital after a choking episode and was incorrectly diagnosed with coronavirus. He was discharged the next day with a DNR form giving the reason as his “blindness and severe learning disabilities”.

Marie-Anne Peters, whose brother Alistair has epilepsy but no other health conditions, overturned a DNR on her brother which included instructions for him not to be taken to hospital.

Peters, from West Yorkshire, said: “If the staff at his care home hadn’t alerted our local health commissioners or MP then who knows what could have happened. My brother has been fighting his whole life and keeps recovering. Why would we give up on him now?”

Both charities fear other people with learning disabilities who are vulnerable could be wrongly denied life-saving treatment. They have now launched a new checklist for families and care workers to challenge illegal DNRs.

Julie Bass, chief executive at Turning Point, said: “It is not only illegal but outrageous that a doctor would decide not to save someone just because they have a learning disability. They have the same right to life as anyone else.

“We hope our campaign and the checklist will help support families and care staff in challenging these orders.”

Scott Watkin, LDE Representative Body co-chair, said: “Decisions on people’s treatment that are based on someone having a learning disability are never OK – even one is too many.

“We’re pleased this guide has been made so people can understand their rights and speak up for themselves or their family member. It’s an important step in helping people challenge poor or illegal decisions. Enough is enough.”

Although a DNR is a medical decision and not something that requires patient consent, not consulting with the patient or their family is an unlawful breach of human rights.

It has come to the fore during the coronavirus pandemic after multiple reports of blanket DNRs being applied to elderly and vulnerable patients by GPs in care homes.

Both the Care Quality Commission and NHS England have issued warnings to doctors that blanket DNRs are wrong and decisions must be made on the individual patient.

Health secretary Matt Hancock has been threatened with a judicial review after the secretary of state repeatedly refused to issue clear guidance on when and how DNRs should be imposed.

During a Court of Appeal judgement in 2014 which granted patients the right to be consulted, judges warned widescale systematic breaches of the law could result in the government being held accountable if its refusal to issue national instructions was linked to wider breaches.


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