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Mason Institute Investigates Episode 3: DNACPR decisions during the COVID-19 pandemic

Welcome to the third episode of Mason Institute Investigates. This episode’s guest is Upeka de Silva (Twitter: @de_upeka), the Policy Officer for the charity organisation, Compassion in Dying (Twitter: @AGoodDeath). Upeka and I discuss the Care Quality Commission’s (CQC) review into DNACPR decision-making during the COVID-19 pandemic, “Protect, respect, connect – decisions about living and dying well during COVID-19“, and the role Compassion in Dying had in the CQC’s report but also the trends and problems surrounding DNACPR decision-making before and during the pandemic discovered by Compassion in Dying in their independent report, “Better understanding, better outcomes: what we’ve learned about DNACPR decisions before and during the Coronavirus pandemic“.

Upeka talks about pre-existing problems surrounding DNACPR decision-making and how the pandemic exacerbated these problems.

“We found that some conversations were rushed, and people and their families were often not properly involved or given clear information about DNR decisions. We had many calls from family members saying, “My mom is in a care home and the GP placed a DNR on her records. No one spoke with me. I don’t know what this means. So, the effect of poor communication and not involving patients and their families is a breakdown of trust with the clinical team and this is really difficult to mend.”

Upeka de Silva

By sharing the experiences of patients and their families, Upeka shows us why communication in DNACPR decision-making is important, and why we need to have these conversations early.

“Underlying all of this should be an understanding that when done well, DNAR conversations really help people understand what is likely to happen if they become unwell and give them the opportunity to ask questions and explain what matters to them.”

Upeka de Silva

Listen to the podcast episode on Media Hopper.

View the accompanying episode transcript (PDF)

Check out the channel of Mason Institute Investigates for other episodes.

For more information, please see the below links to further resources. Happy listening!

Written by Leyla Noury (Twitter: @dheggacad)

Links and further resources:

Compassion in Dying (Twitter: @AGoodDeath)

Compassion in Dying. Better understanding, better outcomes: what we’ve learned about DNACPR decisions before and during the Coronavirus pandemic (2021)

Care Quality Commission. Protect, respect, connect – decisions about living and dying well during COVID-19 (2021)

Resuscitation Council UK. ReSPECT

NHS Wales Health Collaborative. DNACPR. ‘Sharing and Involving – a clinical policy for Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) for adults in Wales’

Scottish Government. ‘Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) – integrated adult policy: guidance’

NHS England. ‘Universal Principles for Advance Care Planning (ACP)’

David Pearce. Are we framing ‘the conversation’ well enough? (2020) Medium


‘Mason Institute Investigates’ is produced and edited by the Mason Institute and made with funding from the Edinburgh Law School.

The intro song is ‘Secret to Success’ by Scott Holmes Music

The outro song is ‘Inspirational Outlook’ by Scott Holmes Music

Both are available under Attribution-NonCommercial 4.0 International Creative Commons Licence from Free Music Archive

Image by fernando zhiminaicela from Pixabay

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