Grieving UK family urges national policy change after hospital issued DNR order without consent

After Janet Tracey, 63, suffered a neck fracture during a car crash, the hospital immediately put a DNR order in her chart, without consulting Mrs. Tracey or her family.
Thu May 8, 2014 - 8:53 am EST

CAMBRIDGE, UK, May 8, 2014 ( – The widower and daughter of a British woman who died at an NHS hospital in 2011 after doctors imposed a do-not-resuscitate order without their permission are urging the national health secretary to issue clear directives concerning DNRs.

Janet Tracey, 63, died at Addenbrooke’s Hospital after suffering a neck fracture during a car crash.  She already had terminal lung cancer, and the hospital immediately put a DNR order in her chart, without consulting Mrs. Tracey or her family.

Janet Tracey wanted to live, so when she saw the DNR in her chart, she became angry and demanded the hospital revoke the order.  But three days later, the hospital issued another DNR, and while they discussed the matter with Janet’s family, they never notified Janet herself.  She died two days later.

Now, Mr. Tracey and Ms. Masters are arguing that the hospital violated Janet Tracey’s human rights by not informing her of her planned fate, and are calling for a uniform national policy dictating exactly how such notifications and decisions shall be made throughout the NHS. 

Currently, there is no national law saying doctors must obtain consent before issuing a DNR.

"At the moment, the policy on managing resuscitation is down to each trust - including each ambulance trust,” Masters told the BBC.  "The end result is that nobody gets any clear information when it comes to patient level. And that can be heartbreaking.”

"The situation really has to change so that no other families are left like mine are. How someone's end of life is handled really does live with the family forever," Masters said.

Mr. Tracey told the BBC, “There needs to be some clarity, so people can understand the situation and what is going on with your particular loved one at the time.”

Merry Varney, an attorney with the Human Rights division of Leigh Day who is representing the Tracey family in court, told the Hertfordshire Mercury: “This case is not about the right to demand to be resuscitated; this case is about whether a patient with capacity has the right to know how DNR decisions are made and the right to know and be consulted before a DNR order is made.”

“This case highlights the distress caused when a patient or their family discover a DNR decision has been made [without consultation].  I believe that in this day and age of patient choice and transparency, it cannot be right that a competent patient should have this kind of unwelcome surprise and we hope this case will bring clarity for patients and families across the country.”

Previously, Judge Nicola Davies tossed out the case, agreeing with hospital officials that Mrs. Tracey’s doctors were acting in her best interest when issuing the DNR.  However, the case has now been picked up by the Court of Appeal, which acknowledged that the handling of the DNR arrangements by the hospital had caused tremendous distress to the Tracey family.  Arguments are being heard this week, with Master of the Rolls Lord Dyson presiding.