Are they being unreasonable

Kiora I'm with you, and I understand what you're mean about the complexity of the situation. Also, just because the patient says it's okay to discuss with the relatives, there is no need to do so in front of the patient, for the very reason that the relatives may feel uncomfortable.

I have personal experience of this, when my mother was dying (and she was reconciled to this), the consultant told my sister and I in a very cold and clinical way exactly what was going on with her (gave us an update), I was stunned by the brutal (to me) information I was receiving and very uncomfortable with the fact that my poor mother was within earshot. And my mother I think sensed my feelings, and reached over and slapped the consultant on the leg (albeit weakly) as if to tell him off.

Anyway, if I know death is imminent or days or hours away, I wouldn't want a ball-by-ball account of when to expect it.

How do you know I don't wear a nightcap, Charley?

annodomini may I suggest that you have DNR tatooed on your forehead rather than your heart because you may be clothed or in your night attire when resuscitated!

I feel exactly the same and I would also want to know everything so that I could make an informed decision.

The Liverpool Pathway is different, and it is no longer being followed because there were fears it was being used inappropriately.

Isn't this what they call the Liverpool Pathway? Or is that something different?

I just want to add I'm not criticising i'v just witnessed the NHS at its best

His own consultant in his hometown ( they were visiting me 250 miles from there) had this conversation with him. His wife said he was ok when he was with the consultant but became very depressed and withdrawn later. Eventually he burst out that he'd been told "there's nothing down for me I'm going to die" his wife then consoled him by saying that's not what they said they were just asking what you would like to do if things got worse. When he was taken ill here and our small local hospital thought the worst may happen they broached the subject with him again and because he just wanted to avoid the conversation he told the consultant to talk with us. I was upset for obvious reasons but mostly because both his wife and I knew he didn't want to hear. It's all so upsetting, emotional and complex. I don't blame the doctor who didn't know him or us. I just think that sometimes your better off not knowing. My little mantra to most things is " if your not prepared for an honest answer don't ask the question" but in this case didn't ask because we didn't want to know but got the answer anyway.

I would want discussion with my relatives to take place in my presence. If I have made an informed decision then discussing it would not be a problem.

I'm a bit confused because I thought kiora said that the gentleman told the doctor he would discuss the matter with his relatives - did that mean he was unsure whether to accept the DNR advice?

I thought, as long as a patient was in a fit state of mind to make such a decision, they had to be consulted as to their wishes. If that's the case, then the doctor had a duty to discuss it.

If I was nearing the end of life and very poorly, I would not want any great efforts to be made to keep me alive - just to be kept as comfortable as possible. I wonder though whether a lot of people think like that in theory and when such a situation becomes a reality, they find that they want to cling on to life for as long as they can.

I intend on asking for DNR to be put on my notes when/if I can when I think the time has come.. the only problem is my OH has a different view and I know doctors will take into account the next of kins wishes too.

I think Doctors can generally when they open up this conversation gauge whether the patient is open to a frank discussion or not.

I was thinking of getting that tattooed over my heart, Galen.

I'm NTBR! Not to be resuscitated

I think it depends on what you (the patient) wants, doesn't it? They seem to have gone from not telling the patient, and sometimes the relatives, anything so as not to upset them, to absolutely full and frank disclosure. One size doesn't fit all. I think I prefer the full and frank but I'm not sure. And how do you approach it? Do you want to be told everything ? is a bit of a giveaway.

Many people do not want the pain and indignity of resuscitation, when it is only to bring them back to more of what they had just escaped.

Resuscitation is not the simple turning back on of a switch to return the patient magically to life and health. It involves heavy physical and electric manipulation of a body which itself has decided that it is time to call a halt. Among other things, ribs can be broken in the process, leading to pain in breathing.

If the consultant had already spoken to the patient, I don't see the problem about repeating the same to the patient's relatives in the patient's presence. So long as it is done sensitively, I think it's the right thing to do and not at all unreasonable.

It does seem to be standard practice now. My elderly Dad was asked if he wanted to be resuscitated in the event of his heart stopping - he told them that yes he jolly well did! This was about 9 months ago.

He has subsequently died, but not in hospital.