RESPONSIBILITY FOR DECISION-MAKING: PROFESSIONAL
The overall responsibility for making an advance decision about CPR rests with the senior clinician (doctor or nurse) who has clinical responsibility for the patient during that episode of care. This will usually be the medical consultant (in General Hospitals) or the General Practitioner (in the Community based Hospitals, Care Homes or the patient's home). However, it is also reasonable for other grades of experienced medical staff and experienced senior nursing staff to take responsibility for this decision provided that they accept that they have clinical responsibility for the patient during that care episode. It is appropriate that the decision that CPR should not be attempted should be made in consultation with other members of the care team such as medical colleagues including general practitioner and senior nursing staff. For hospital inpatients Junior Doctors with full GMC licence to practise can sign the DNACPR form but the decision must be fully discussed and agreed with the responsible Senior Clinician who should then sign at the next available opportunity. Junior doctors without full GMC license to practise (i.e. Foundation Year 1) should not make this decision.