UK nurses given power to end a life under controversial new guidelines*

By DANIEL MARTIN -

UK Nurses will be able to decide that a dying patient should not be
resuscitated under controversial new guidelines.

Until now, only GPs and consultants could say whether there was any
point in continuing efforts to save a life.

But guidance issued last night by the British Medical Association will
allow 'suitably experienced nurses' to make this crucial decision.

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New powers: A senior nurse attends to a critically ill patient, but she
could soon be deciding whether to proceed witih treatment at all (posed
by a model)

Patients' groups criticised the move, calling it 'another nail in the
coffin' of the safety of the elderly and vulnerable which would condemn
many to an 'early death sentence'.

The rules, published by the BMA in conjunction with the Royal College of
Nursing and the Resuscitation Council, aim to help medical staff decide
whether to resuscitate patients if their heart or breathing stops.

It says medical staff should use their judgment over whether there is
any point in using the most common resuscitation method - chest
compression, or 'cardiopulmonary resuscitation'.

But for the first time, this includes 'suitably experienced nurses'.

In the past, nurses faced with such a situation would have carried on
until a GP or a consultant made the decision to give up hope.

The new guidelines, which cover hospitals, hospices and ambulances, were
introduced because some experts feel that sustained rescuscitation
efforts can be undignified and often worthless.

The RCN said only consultant nurses or senior nurses who have a
supervisory role would be able to make these decisions.

General secretary Dr Peter Carter said: 'This joint guidance recognises
the important part that nurses play in decisions related to resuscitation.

Dr Vivienne Nathanson of the BMA added: 'In TV medical dramas, CPR is
often the wonder intervention that saves patients' lives and reunites
them with their loved ones.

'Unfortunately, in real life the survival rate after a patient has a
cardiac arrest and receives CPR is relatively low.'

Nurses will only be able to make such decisions if their local hospital
trust agrees they can.

The Department of Health leaves it up to professional bodies such as the
BMA issue guidance and individual trusts decide how to implement them.

SOS-NHS Patients in Danger, a group formed by relatives who believe a
loved one died because of deliberate starvation, dehydration or
with-holding of medication, have criticised the guidelines.

Spokesman Julia Quenzler said: 'This sounds like yet another nail in the
coffin for vulnerable elderly patients.

'By giving a senior nurse this power, is it yet another means of
distancing doctors from their patients' deaths?'

Katherine Murphy, chief executive of the Patients' Association, called
for greater clarity over which nurses should be allowed to take
life-or-death decisions.

'We would hope that these senior nurses will be properly qualified and
in a position to make these decisions,' she added.