Deaf News: Deaf man allegedly given ‘Do Not Resuscitate’ order without his consent following “communication difficulties”

A Deaf British Sign Language (BSL) user from Scotland was allegedly handed a ‘Do Not Resuscitate’ (DNR) order by NHS Scotland, without his knowledge or consent, because of “communication difficulties” – according to the charity Deaf Action.

A DNR means health staff will not attempt to restart a patient’s heart or breathing if either of them stops, and the man – from the organisation’s supported accommodation in Slateford Green, Edinburgh – was handed one during his recent routine hospital appointment.

Alison Richards, Support Manager at Slateford Green, said her team was “shocked” when they were handed the letter by the gentleman.

“He had no idea what it was, so asked us about it. We can’t believe he was given a DNR order without consulting with him.

“Everybody has a right to make a decision about their health, and that includes deaf people.”

The order, shared by Deaf Action on their website, shows the completed form with the question, “the patient is aware of this decision”, and the option “no” being ticked.

It goes on to read: “The presumption is that the patient, and those close to the patient who lacks capacity, will be aware of the [Do Not Attempt Cardiopulmonary Resuscitation] decision […] Where the conversation has not yet happened, the full explanation and a clear plan to revisit this must be documented in the clinical notes.”

However, the note says that the man could not be informed of the decision taken on his behalf because of “communication difficulties”.

Once Deaf Action were alerted to the issue, the charity discussed the order with the individual and arranged a GP appointment to discuss the DNR, with a BSL interpreter present.

“It’s a shocking failure that ‘communication difficulties’ were cited on this DNR order. British Sign Language was formally recognised in Scotland in 2015, so deaf people have a legal right to access information in BSL.

“Provision for language interpreters is absolutely vital – they provide smooth communication between health professionals and BSL users, and that communication can stop problems like this from happening in the first place.

“It doesn’t matter what language we use – ‘communication difficulties’ should not be a reason to potentially end a person’s life,” added Gordon Hay, Head of Operations at Deaf Action.

The incident is the latest case of DNRs being issued without a meaningful discussion with the patient or family members, with BBC News reporting that more than 500 DNRs made since March last year were issued without consultation.

Photo: Deaf Action.

By Liam O’Dell. Liam is a mildly deaf freelance journalist and campaigner from Bedfordshire. He wears bilateral hearing aids and can be found talking about disability, theatre, politics and more on Twitter and on his website.

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Update: Dr Tracey Gillies, medical director at NHS Lothian – the NHS Scotland provider alleged to have issued the DNR – said in a statement: “Without any patient information we are unable to verify the details of this claim or whether this man is a patient of NHS Lothian.

“There are very clear protocols in place around Do Not Resuscitate (DNR) orders to ensure they are fully understood by patients and their family or carers. NHS Lothian has a policy for ensuring that appropriate support is provided to any patient for whom spoken English is not their first language, which includes a robust BSL interpreting service.

“We have two in-house full time BSL Interpreters and we have a Service Level Agreement with Deaf Action to supply additional on call or out of hours cover to ensure services can be provided 24/7 at any time of year.”

The BSL interpretation service, provided by Deaf Action, has run since April 2021 and NHS Lothian say the deaf charity would “routinely liaise on behalf of clients in their care” to make sure the appropriate support is in place for Deaf people attending hospital appointments.

“We strongly encourage anyone who has a concern about any of our services to discuss it directly with us or lodge a formal complaint so that it can be investigated fully,” Dr Gillies added.

Deaf Action has since confirmed to The Limping Chicken that the gentleman’s DNR order was later lifted.