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NEWS: Practice apologises over DNR letters

by in Coronavirus, COVID-19, GP Practice Management, News

A practice has had to apologise after posting ‘do not resuscitate’ forms to a number of patients along with a “frank and realistic” letter.

Llynfi surgery, in Maesteg near Port Talbot, said in the letter that signing the form would ensure that emergency services would not be called and resuscitation not attempted “in the event of a sudden deterioration.” One of the benefits would be to ensure “scarce” ambulance resources were targeted to the young and fit “who have a greater chance,” the Guardian reported.

Cwm Taf Morgannwg University Health Board issued a statement, saying: “The surgery have been made aware that the letter has caused upset to some of the patients who received it. This was not their intent and they apologise for any distress caused. Staff at the surgery are speaking to those patients who received the letter to apologise directly and answer any concerns they may have.”

It happened as GP leaders backed new ethical guidance for the care of patients during the virus crisis. The presence of Covid-19 infection should not be a “limiting” factor in treatment decisions over the next few weeks, according to new ethical guidance.

Care should be provided in a “fair and equitable” way and all beds should be allocated according to continual assessment – to ensure the most needy patients get priority, according to the guidance issued by the Royal College of Physicians. The college says the guidance is supported by several other royal colleges and specialist faculties, including the Royal College of GPs.

The guidance advises doctors to ensure they follow protocol when making decisions – and that “ideally” more than one clinician should be involved. It remains important to discuss care with patients and their carers and to record decisions, it says.

The guidance also seeks to provide support for doctors concerned about inadequate protection, stressing their “right” to protect themselves. It is ethical to refrain from giving treatment or being involved in the care of Covid-19 patients if there is risk of harm to the doctor, perhaps through age or underlying conditions, it says.

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