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A GP is urging patients and their families to consider whether they want to be resuscitated in the event they fall seriously ill.
Dr Peter Gilbert, of the Thorndike Medical Centre in Longley Road, Rochester, has written to patients of the surgery, suggesting they discuss their wishes and outline them formally in an Advance Decision notice.
Speaking to the Medway Messenger, Dr Gilbert said he was aware some felt they did not want doctors to "interfere or prejudge their decisions about their medical treatment", but stressed he was simply encouraging people to think about an issue that many prefer to avoid.
"Our aim is to encourage people to discuss their wishes with their relatives and if they can take that further step, to write their wishes down in an Advance Decision," he said, adding: "Although most people who decide to write one are looking to decline aspects of treatment such as resuscitation, it is equally valid to create one saying, for example, that the individual wishes to have all the treatments that the NHS can provide in every circumstance. So it puts the power firmly in the hands of the patient and removes the uncertainty that exists about the patient's wishes in the vast majority of admissions with serious illness."
He also stressed the difference between a formal Advance Decision and a Do Not Attempt Resuscitation directive (DNAR), adding: "While twice in the document we give links to the Advance Decision, we deliberately don't give any specific instructions as to how to go about a DNAR, other than to contact us, as it's very much not the result that we are trying to encourage. It has to be signed by a doctor, and therefore can very much be seen to be influenced by the doctor. The Advance Decision can give specific directions about resuscitation but leaving the power in the hands of the patient."
The document sent out to patients asks them to consider a number of scenarios, and lists three categories of patients who might have a different view on resuscitation.
A summary states: "If you are a fit healthy person who has an unexpected cardiac arrest and there are people nearby who know how to resuscitate you by performing cardiopulmonary resuscitation (CPR), you have a small but realistic chance of a successful outcome which I and many would always see as worth fighting for.
"If you have several pre-existing illnesses and you have an unexpected cardiac arrest in normal circumstances and with people nearby who know how to resuscitate you by performing CPR, you have a very small chance of a successful outcome which you may consider to be worth fighting for.
"If you are seriously ill in hospital with an illness such as sepsis, overwhelming coronavirus infection or a very severe pneumonia with existing lung, heart or kidney disease and your condition is deteriorating despite active treatment in Critical or Intensive Care, even though the hospital resuscitation team is nearby, your chance of a successful outcome is effectively zero."
And the leaflet adds: "Resuscitation is a brutal and physically damaging process in which your breastbone must be pushed 2 to 2.5 inches into your chest, 100 to 120 times a minute. Many people will not survive this, even if it is attempted. Some people already know they don’t want it."
Dr Gilbert also stressed that the leaflet was only concerned with situations where someone's heart had stopped beating, and that it had "nothing to do with the care anyone receives up to that point, which will always be the best available."
