DNACPR - Do Not Attempt Cardio-Pulmonary Resuscitation

This policy is based on the South East Coast Strategic Health Authority Policy Do Not Attempt Cardiopulmonary Resuscitation Principles (DNACPR).

There is evidence to suggest that, for terminally ill patients, the harms of cardiopulmonary resuscitation (CPR) are likely to far outweigh the possible benefits.  Evidence indicates that where cardiac arrest occurs out of hospital, the survival rate to discharge is at best 5-10%.

Hospice in the Weald (HitW) has no facilities for advanced life support.  A principal focus of our care is to try to ensure dignity throughout the dying process and affirm death as a natural part of life.  The decision to transfer patients for active resuscitation is a multi disciplinary one and is decided on an individual basis.  This decision should be made explicit to all health care professionals concerned with caring for that patient and the wishes of the individual lie at the heart of this decision.

Making a decision not to attempt CPR that has no realistic prospect of success does not require the consent of the patient or those close to the patient. It is good clinical practice to discuss major decisions about care with patients and / or their families and this includes decisions about DNACPR.  There should be a presumption in favour of patient involvement and there need to be convincing reasons not to involve the patient. However it is inappropriate to involve the patient in the process if the clinician considers that to do so is likely to cause the person to suffer physical or psychological harm.


The above is an extract from our DNACPR policy.  To continue reading the full document, please click here.