My experience of signing the DNACPR form
Until recently I refused to put DNR on my mother's medical record because past experience with elderly relatives in hospital showed me that standards of care vary widely from ward to ward, let alone hospital to hospital; I could not be sure that if my mum was hospitalised that a DNR might not be interpreted as "don't try too hard."
DNR does not mean 'do not treat'; it just means don't get the heart started again if it has stopped. Decisions about how far you go with medical treatment should be taken by doctors, in consultation with the patient and family, depending on circumstances. Ultimately a clinical judgement should be made on whether the patient will benefit or suffer from treatment, and whether the current episode is survivable. That is very different to the specific issue of cardio-pulmonary resuscitation.
Recently my experience has been that medical staff have a clearer understanding of what DNACPR means (Do Not Attempt Cardio-Pulmonary Resuscitation). This means if the person's heart stops there should be no jump-starting the heart with paddles, no chest compressions, no rescue breathing. I have therefore signed the form with my mum's GP. The DNACPR instruction, plus an abbreviated form of her medical record, will now go online and be available to the emergency services via their onboard computer system. This is in Scotland - I don't know if it is the same across the UK.
Having consulted my brothers, and my OH who is joint Guardian with me, we came to a unanimous view that my mum, now aged 90, with a weak heart, would not survive CPR or would linger in pain with a poor quality of life for a short while, and then die anyway. The GP agreed that this was his view also.
However, when we were getting ready to sign the DNACPR form, the GP said that we could add further instructions about not giving life-prolonging treatment, as guidance to hospital staff. I felt that this was a step too far. We will make those decisions, if they need to be made, on the facts and circumstances as they appear at the time.
At the moment if my mum needed antibiotics, or steroids, or oxygen, this would be to get her over an illness and back to better health. She isn't in poor spirits and has a good quality of life. It is too soon to say 'do not treat'. Obviously, for other families this is not the case, and they might want to indicate that palliative care only is the kindest course of action.