[waterhouse]

You will have seen the news report that a family is suing Addenbrookes Hospital over the death of one of their number.  Apparently a Do Not Resuscitate note was made on the file and the family objected.  I don't know the facts and it's all sub judice now but the odd thing was the quote by a relative

"We believe mum's experience is a consequence of a lack of clear policy on decisions relating to end-of-life care.  A clear and national policy is needed.  It should not be the case that there is a different policy from area to area.  This just does not make any sense"

Now her mother entered hospital with terminal lung cancer but also with a broken neck as a result of a road accident.  She died 16 days later.

How many people enter hospital in the UK with that combination of problems each year?  Or to put it another way how long would the policy document have to be to provide guidance for every life-threatening situation?  Are we not trying to take hugely subjective matters and codify them?  Should we not leave these things in the hands of those who have the clinical knowledge and experience to decide.  Someone's death is never going to be much fun, after all

[little blue]

 a DNR is the patient's choice, surely it disregards the cause of hospitilisation.

I hope my wishes are respected when the time comes, both by family & hospital staff...

[Hatty]

DNR is not always the patients choice but is usually discussed with them as far as I know, my Dad died from terminal Lung Cancer 4 years ago and DNR was put on his notes by the consultant and I was glad. Towards the end I was asking if there was anyway they could give him to much morphine, and end things quicker, he collapsed in Turkey on holiday,spent 4 days in hospital there, flew home (cost us £15000 insurance wouldn't cover) and lasted just 10 days when we got him home, you wouldn't watch an animal suffer for that long it was awful, if she went quick they should think themselves lucky

[knightquest]

They're probably after the compensation - too cynical?

Ian

[tizaala]

The way things are looking  now , as soon as you reach 65 and are likely to be claiming your pension the government will instigate a policy of involuntary euthanasia as you are no longer economically viable.

[ellied]

My mum had a DNR on her notes at her request on the day she died, I was told afterwards..

Sadly as my older sister was listed next of kin and was expected at visiting time (and made it as mum was fading with 10 minutes to spare) I wasn't informed of her rapid decline and as a result was only told by phone when my sister arrived by which time it was too late for me to get there

I have to assume it really was mum that initiated or agreed to this, but it is one of the things that haunts me even now.

I know nothing of the court case in question so can't comment..

[shetlandpaul]

it would be cruel and pointless to do cpr on a person who has late stage cancer. you would be causing them more pain and very likely causing them injury. cpr is not a gentle thing. if this lady had a broken kneck as well it would have made it even more dangerous. DNR is totally diffrent from not treating there condition. really its just the person dying from their condition. very sad but death can and is better than life sometimes. what the goal should be is a good death.

[shearling]

More like 68 - I have just had my minimum pension age moved by the government and by the time I get there no doubt it will then be in the 70's

The way things are looking  now , as soon as you reach 65 and are likely to be claiming your pension the government will instigate a policy of involuntary euthanasia as you are no longer economically viable.

[doganjo]

My mum had a DNR on her notes at her request on the day she died, I was told afterwards..

Sadly as my older sister was listed next of kin and was expected at visiting time (and made it as mum was fading with 10 minutes to spare) I wasn't informed of her rapid decline and as a result was only told by phone when my sister arrived by which time it was too late for me to get there

I have to assume it really was mum that initiated or agreed to this, but it is one of the things that haunts me even now.

Ellie, don't beat yourself up about it.  My Mum refused cancer treatment knowing exactly what she was doing.  Towards the end I was called, and stupidly went for my husband and son first. As a result by the time I got into the hospice she had just gone.  But I had said my goodbyes before I left, and my Aunt(the one that';s just died) and her daughter were there, and my sister arrived soon after. so she was well loved at the last.  I'm sure your Mum knew your love for her.

[smallholder in the city]

It's been a while since I had to do one but hospitals generally have their own guidelines but most advise a discussion with patient and family, whilst ultimately putting the responsibility for the final decision with the senior clinician, the consultant who can always request a second opinion if they want to. I think treating each case individually is more sensible than trying to legislate for everything.

And yes DNR does not mean don't treat, and CPR is not a pleasant thing to undergo.

I feel desperately sorry for the family who are clearly in the midst of grief and need something to hold onto /distract them from it, perhaps they weren't prepared for what happened (sometimes there just isn't time and sometimes people can't hear what they are being told) and perhaps someone neutral needs to spend time with them explaining that it's Ok to be angry but a court case won't bring her back.   

[waterhouse]

My brother, who is a medic, was very upset when our mother died.  He talked of disputing the death certificate and didn't believe the hospital had done all they could.  But then he'd lived 200 mi away and OH and I had done all the visiting, mending things and fetching and carrying for the decade after dad died.  In her last few weeks something was going wrong but it wasn't showing in the innumerable blood tests.  She died just shy of 90 and was ready to go. I think she died of getting old, things were just not working properly, but apart from the last six hours she was in her own home.

I think anger and guilt turn up in these cases.  The peaceful end surrounded by a grieving family is a rarity, it seems.

[Hatty]

I think anger and guilt turn up in these cases.  The peaceful end surrounded by a grieving family is a rarity, it seems.

My Dad died during the awful floods in 2007, couldn't have him home because the whole town was flooded (needed specialist equipment and they couldn't get it to us), I couldn't get home (live about 8miles away) so spent the last 7 days in a chair by his side, on my own! Mum visited a couple of times a day she lives just over the road from the hospital, he was never alone, only when he went to sleep did I go for a walk or down to theatres to watch telly/share a Chinese (BF staff nurse) I was there when he died a felt comforted by knowing I had been there for him, I know the hospital did all they could.in the circumstances, but other members of the family who couldn't get there tried making a fuss  my Dad had only been retired 18months he was not old, I feel privileged I was able to be there for him, giving back a little for all the times he'd been there for me! I know I was lucky as not everyone can do what I did

[mmu]

This is a very thought- provoking subject.  We often say "I hope I die before I get old" but there's nothing wrong with getting old, it's getting ill and old. that's the problem.  Surely if we choose our health professionals with more care, making sure that humanity was as high on their list of qualifications as their skills, and then left life or death decisions to them, getting old, being sick, and ultimately dying might become a far less frightening process for all involved.  We do, after all, have our animals put down before things get too bad for them, if at all possible, Even though it's sometimes a very difficult decision, it's our responsibility to take it, so surely, when people we love are dying it's best to let them go, however badly that affects us.

[shetlandpaul]

easier said than done. a good death requires all the people involved in the care of the person knowing what is happening. we are lucky up here the gps are willing to care for the person at home. unless the person needs specialist care hospital is the wrong place to be.

[doganjo]

My aunt died last Sunday morning.  In her own home, but as it happens she was alone at the time - however, the circumstances gave her the very absolute best death ever.  My uncle went for the Sunday papers leaving her eating her breakfast.  When he came home he found her sitting with the spoon of cereal in her mouth.  No disturbance, her heart had just stopped.  She was 85 and Uncle John is 88.  She had high blood pressure and a heart condition but was not expected to die anytime soon.  She also had a non aggressive form of breast cancer so we all are sad to have lost her but happy that she went before the cancer gave her any problems, and with no pain or suffering.  Goodbye Auntie Bel