Right to Life
Advocates work with the Right to Life around Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) orders. These are decisions that are recorded on special forms, which tell health care workers whether or not CPR should be attempted, if the person’s heart or breathing stopped. They are decisions that are made and recorded before an emergency situation arises.
Wherever possible, a conversation takes place between the person and their health care workers so that the person understands what the decision means for them.
There might be times when the person can’t take part in the conversation, maybe because they are too poorly, or haven’t got the mental capacity to. In these cases, the health care workers should speak with family or friends who know the person well to get an idea of what they might want.
If the person hasn’t got family or friends who can give that information, and has been assessed as not having the capacity to take part in the decision themselves, that’s when an advocate might become involved.
An Independent Mental Capacity Advocate (or IMCA for short) would ask if the person might regain capacity, and if so could the decision wait; speak with the person to see if they are able to say what they think about the decision; check if there were any disagreements about the decision; talk to the person who will make the decision (maybe GP or hospital worker) to gather information about what a realistic outcome of CPR might be.
The IMCA then writes a report for the decision maker, which has to be considered by them.
Having an independent advocate involved means that decisions about whether or not to attempt CPR, if it’s needed, are not made by any one person or a group of people working in the same field, but are influenced by broader information gathered by someone who is independent, and our involvement helps to ensure that best practice around this really important decision is followed.