Responsibility for Decision-Making: Professional
The overall responsibility for making an advance decision about CPR rests with the senior clinician (doctor or nurse) who has clinical responsibility for the patient during that episode of care. This will usually be the consultant (in general hospitals) or the general practitioner (in the community-based hospitals, care homes or the patient's home). However, it is also reasonable for other grades of suitably qualified and experienced medical and senior nursing staff to take responsibility for this decision provided that they accept that they have clinical responsibility for the patient during that care episode. At a local level, multidisciplinary teams must be clear about which members of their team are able to take on this responsibility. A decision about CPR should be made in consultation with other relevant members of the care team who have knowledge of that patient.
Where a DNACPR decision has been established with certainty the healthcare professional documenting the decision can sign the form in any hospital or community setting but the decision must be fully discussed and agreed with the responsible senior clinician who should then sign the form at the next available opportunity.
Email: Elizabeth Gourlay, firstname.lastname@example.org