CPR Decisions, DNACPR and ReSPECT

CPR isn’t always the best treatment for an individual. That’s why CPR conversations need to happen.

A patient and a health professional have a conversation

Life – and death – matters.

Here at Resuscitation Council UK, our research, training and guidance allows healthcare professionals to save lives. We do this because for many people who experience a health emergency, they wish to be given a chance of survival and recovery.

In that event, we will do anything we can to save lives. But for people who are unlikely to survive even with resuscitation attempts, a decision around CPR can increase the possibility of a peaceful and dignified death. 

Likewise, for those who have made a personal decision to have a CPR or healthcare decision recorded, it allows them to do things on their own terms. 

There are many ways to map out the care you’ll receive in an emergency.

DNACPR

DNACPR stands for ‘Do not attempt cardiopulmonary resuscitation (CPR)’. It means that if a person has a cardiac arrest or dies suddenly, there will be guidance on what action should or shouldn’t be taken by a healthcare professional, including not performing CPR on the person.

There are many reasons why a person might have a recorded DNACPR decision.

Some people choose to have one simply because they do not want to be resuscitated in an emergency. They might have a personal reason to make this decision, but this varies depending on the individual.

Others make the decision along with their health care provider, after experiencing health issues that might inform their decision.

There are also occasions when healthcare teams may have to make decisions on behalf of patients. In this case, they would try to involve patients or their loved ones wherever possible. This might happen because a patient is so unwell from an underlying illness, that CPR will not prevent their death. By making the decision on behalf of the patient, there is an opportunity for the patient to have a peaceful, dignified death.   

DNACPR only specifies whether a person will receive CPR or not. Patients will still receive appropriate treatment for their health issues and all personal care needs will be attended to.

Other ways of making decisions

For people who also want to create a personalised plan for other types of care and treatment, there are some other processes and decision-making forms in place. These include:

ReSPECT

The ReSPECT process creates personalised recommendations for a person’s clinical care and treatment in a future emergency in which they are unable to make or express choices. It is currently available in many areas of the country.

These recommendations are created through conversations between a person, their families, and their health and care professionals to understand what matters to them and what is realistic in terms of their care and treatment.

Patient preferences and clinical recommendations are recorded on a non-legally binding form which can be reviewed and adapted if circumstances change. 

Find out more about ReSPECT

Advance Decision to Refuse Treatment (ADRT)

An ADRT enables someone aged 18 or over, while still capable, to refuse specified medical treatment for a time in the future when they may not be able to do so.

It is a legally binding document that allows the individual to express their wishes while they are able to make decisions and communicate them in advance of a possible emergency.

To find out more, take a look at the NHS page on Advance Decisions.