By Sophie Goodchild and Anna Davis
The Evening Standard
LONDON — Paramedics are being ordered not to resuscitate patients who want to die after a serious accident, the Standard can reveal today.
The guidance from London ambulance chiefs has government backing. But it will fuel the debate over how far medical staff should go in prolonging life. The London Ambulance Service says new laws strengthening patient rights mean paramedics have a duty to respect people’s wishes ‹ even if this means allowing them to die.
But doctors and campaigners warn this system, where healthy people register their “death wishes” in advance on a secure database, could be open to abuse. Dr Tony Calland, head of the British Medical Association’s ethics committee, said: “The risk for healthy people who sign up to this database is they could be in an accident in 30 years’ time and could have changed their mind.”
Andrew Harrop from Age Concern and Help the Aged said: “When making such an important and personal decision, people must receive all the relevant information. It’s paramount that public bodies always satisfy themselves that people are making an informed choice and are always vigilant for potential abuse.”
This is understood to be the first time an ambulance service has registered the wishes of healthy people who do not want to live if their quality of life is impaired.
It comes in response to guidance issued by the NHS in October 2007 over how to deal with terminally ill patients who are also covered by the LAS system.
A patient, doctor or individual fills in a special legally binding form detailing their end-of-life wishes and these are then registered.
The database is used by control room staff who brief crews when they receive an emergency call. David Whitmore, who set up the secure database, told the Standard the guidance helped prevent difficult situations where a relative asks paramedics to revive someone against their will.
“Do not resuscitate” cases are among the total of 1,624 people already registered with the LAS.
Mr Whitmore, a senior medical adviser with the LAS, said: “A paramedic’s ethos is to save a patient’s life if they can. But it’s also about respecting a patient’s wishes and we must legally go with that.”
The Department of Health emphasised that such advance decisions had to be made in writing and be legally water-tight.
A spokesman said: “We would support any initiative to help publicise and educate people about end-of-life decisions, including advance decisions.”
Patients’ rights
The Mental Capacity Act of 2007 increased the rights of people to control their own medical treatment. It applies to anyone able to make their own decisions and medics are obliged to respect these decisions as long as they are in writing and legally water-tight. Actively helping people to kill themselves is still a crime.