Public hospitals seek extension of 'do not revive' guideline

PUBLISHED : Saturday, 05 January, 2013, 12:00am
UPDATED : Saturday, 05 January, 2013, 4:06am

Public hospitals want to extend a guideline that allows chronic and critically ill patients to choose death rather than being revived by emergency procedures.

It is proposing that the option should not be confined to people dying in hospital but include critically ill outpatients.

"It should not be confused with euthanasia as they are totally different," said Dr Tse Chun-yan, chairman of the Hospital Authority's clinical ethics committee. "Giving up medication that is useless in curing a patient is legal and morally acceptable."

The new proposal, now under consultation, will also rename a 15-year-old guideline Do Not Resuscitate (DNR) to Do Not Attempt Cardiopulmonary Resuscitation (DNACPR). If the patient is unconscious, doctors will seek consensus from relatives to sign the document. In their absence, at least two doctors would have to approve the decision.

Tse said more critically ill patients, such as cancer sufferers or those with irreversible diseases, would be spared the pain they would otherwise endure after being revived by cardiopulmonary resuscitation (CPR), which involves chest compression, mouth-to-mouth breathing and an electric shock. "Patients rescued by the procedure may suffer from broken ribs and damaged organs. Even though their hearts start beating again, they may suffer brain damage or organ failure. A majority either die … later or are never able to leave hospital."

But the Patients' Rights Association worried that extending the guideline may cause disputes. Spokesman Tim Pang Hung-cheong said: "We often receive complaints from relatives accusing doctors of not saving their loved ones. As death talk is still a taboo in the Chinese community, families may not discuss and be fully aware of the wish of a patient to choose to die."

The consultation ends in March and the new system could be introduced this year.