Recent decisions about 'do not attempt cardiopulmonary resuscitation' (DNACPR) orders have highlighted the peculiar exceptionalism around cardiopulmonary resuscitation (CPR).
What other intervention with such a low success rate, invasive nature, potential for causing suffering, and failure to improve the underlying medical condition(s) would not only not require consent, but require a quasi-consent process in order for doctors to decline to offer it when it is futile?
Imagine an operation that had the same characteristics as CPR. The law would rightly require that doctors carefully explain the harms and benefits of such a procedure carefully, otherwise the intervention would be deemed an assault (all the more so subsequent to the decisions in Chester v Afshar and Montgomery v Lanarkshire Health Board).
However, the conversation about CPR cannot as a matter of law result in the doctor being compelled to offer a medically contraindicated and futile procedure. It is merely required to ascertain the patient's wishes. They can be ignored. Further, the mere prospect of upsetting the patient (and family) unnecessarily is not enough for this discussion to be circumvented. There has to be the prospect of harm.
This is an unacceptable interference in the doctor-patient relationship, and undermines medical professionalism. It will relegate the discussion of CPR to a technical task defined by the courts, and has the potential for completely reversing the efforts being made to enable a comfortable natural death where appropriate.
Doctors like Knut cannot hold back the inevitable forces of nature. They cannot "play God" when the demise of a frail patient is imminent and thus CPR futile (and barbaric).
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