Doctors to be ‘reminded of responsibilities’ over DNRs for people with learning disabilities
Doctors will receive advice from ministers about the use of do not resuscitate orders for people with learning disabilities, a health minister has said.
Caroline Dinenage told MPs she was concerned to learn that some doctors have recorded learning disabilities or Down’s Syndrome as a reason for granting a do not resuscitate order, according to a leaked report.
Ms Dinenage (pictured) said: “I am concerned, as honourable members are, of any suggestions of doctors recording learning disability or Down’s Syndrome as a reason for a do not resuscitate.
“People with a learning disability have exactly the same right to enjoy a meaningful life as everyone else and their disability should never ever be used as an acceptable reason for a do not resuscitate order.
“We are taking immediate steps on this to ensure that doctors are reminded of their responsibilities and avoid any form of discrimination in this case.”
Former minister, Labour’s Steve McCabe asked if disciplinary action would be taken against clinicians.
He added: “Surely this isn’t a matter of mild neglect requiring a reminder letter. This is a grave abuse of power perpetrated on some of the most vulnerable people in our society.”
Ms Dineage replied: “As I have said, we are already writing to reinforce the message which should be self-evident that should never be a reason for a do not resuscitate.”
An urgent question was granted in the Commons after the annual report from the Learning Disabilities Mortality Review was leaked to The Sunday Times.
It showed that 19 patients between July 2016 and December 2018, who later died, had “learning disabilities” or “Down’s syndrome” listed as a reason for granting a do not resuscitate order.
Former minister for disabled people Mark Haper called on the Government to go further.
He said: “It appears in these cases, without wishing to prejudge them, that a doctor has made that decision without having had that discussion – can the minister also make it clear in her communication that the presumption should be that someone with a learning disability is just as capable of making these difficult decisions as everyone else and that should be the assumption.
“There lives are worth as much as everybody else and that should be the presumption of everybody working in the National Health Service.”
Ms Dineage replied: “Treatment decisions must be based on objective information and should never ever be based on assumptions about a person’s quality of life. We are very clear that a learning disability should never be used as a reason for do not resuscitate.”
Bob Blackman (Harrow East), told MPs his sister, who turns 60 this year, was born with “profound learning disabilities” and he has seen “far too many young people who have suffered from learning disabilities die premature deaths”.
He added: “One of the biggest problems is when someone with learning disabilities suffers a physical problem and has to go to A&E or through the primary care system – if a doctor or surgeon diagnoses that individual, part and parcel of the communication is taking the patient and getting a response.
“People with profound learning disabilities can’t do it, so doctors often, and I have to say I have personal experience where doctors have issued DNRs on people that are perfectly capable of living a perfectly good quality of life.
“Can my Right Honourable friend ensure that individuals who have profound disabilities will have a named person from the health service who will give advice before any such decisions are made?”
Ms Dineage said: “I am very grateful to my honourable friend for that very impassioned plea. I think he makes an excellent point.
“We have already spoken today quite comprehensively about how it is very important that people with a learning disability are never written off and do not resuscitate. It is absolutely wrong.”
Earlier, Speaker John Bercow issued a strong rebuke after Ms Dineage questioned why he “should see fit to grant” an urgent question on the Learning Disabilities Mortality Review.
Ms Dinenage told MPs: “I would like to record my deep regret at this apparent leak, it’s also my regret that Her Majesty’s Opposition should table a UQ (urgent question) based on leaks and indeed that the Speaker’s Office should see fit to grant it.”
Her comment prompted Mr Bercow to intervene: “I have made a judgment that this matter warrants the attention of the House and that judgment is not to be argued with or contradicted by a member of the House.
“The minister’s duty is to come to the House and to answer the question, but don’t argue the toss with the chair, that’s the wrong way to behave.”
Copyright (c) Press Association Ltd. 2019, All Rights Reserved. Picture (c) Dominic Lipinski / PA Wire.