The use of Do Not Attempt Resuscitation Orders (DNAR) has received a fair amount of coverage in recent weeks, and will be discussed on today's One Show (on BBC1 at 7pm). It's a sobering subject but one of huge importance.
The law allows us all to refuse medical treatment at any time we're offered it, providing we have the mental capability to do so. As well as this legal right, we also have the right to refuse treatment in advance of a loss of capacity - in an Advance Decision (often also called a Living Will).
In an ideal world we would all be competent and conscious to make each care and treatment decision as and when they need to be made, but in reality this isn't the case, and if we haven't made our wishes clear in an Advance Decision (or given a trusted person formal Lasting Powers of Attorney to make decisions for us) the healthcare team must work out what's in our best interest. What a doctor thinks is best for you or I may, however, be at complete odds with what we would want, but by that time it's too late.
I made an Advance Decision six years ago when I was a healthy 21-year-old who knew, based on the experience of nursing people in a variety of situations, what I was and wasn't willing to endure at the end of my life. The range of people I cared for as part of my job as a nursing assistant was vast.
One was a man who suffered a severe brain injury in a head on collision with an articulated lorry while driving home from work on his motorbike, aged 33. Another, a 91-year-old man who died in his chair at home, as he wanted, with his terrier Frank on his lap, listening to Bach. Until we get there none of us knows what the end of our lives will look like, but we are not completely powerless and if we know what we want, we should take responsibility for our own end-of-life choices.
Compassion in Dying, the partner charity of Dignity in Dying provides Advance Decisions forms for free, and has recently launched an information line to provide people with information and support on their end-of-life decision-making rights.
I would urge anyone who knows what they do and don't want at the end of their lives to discuss their wishes with their loved ones, make an Advance Decision, ask their GP to lodge it in their medical records and review it every few years.
It gives me a huge comfort to know that if I end up in a head on collision with an articulated lorry, or any other situation that leaves me persistently unconscious, because of my Advance Decision it will be my wishes that are carried out, not those of the medical professionals who have likely never met me.
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