News,

New guidelines governing 'do not resuscitate' orders (DNRs) in British hospitals have been announced by the government. The list of criteria, drawn up by the Resuscitation Council with the support of the Royal College of Nursing and the British Medical Council, stipulate four circumstances in which a DNR order may be appropriate: if resuscitation is unlikely to succeed, if a mentally competent patient had clearly expressed a wish not to be resuscitated, if an advanced notice or so-called living will exists to the effect that resuscitation should not be attempted, or if resuscitation is likely to lead to a poor quality of life and so is not in the patient's best interests. The chief executives of National Health Service trusts will become personally responsible for policy regarding DNRs and a non-executive trust director will oversee the issuing of such orders. Furthermore, a new Commission for Health Improvement will conduct regular hospital inspections to assess the DNR decisions. Every hospital has been asked to implement a resuscitation policy by next April which involves both patients and their relatives, in order to address concerns at news that DNRs have been issued by junior doctors without consultation. Gordon Lishman, director general of Age Concern, welcomed the guidelines and said: "The fact that the resuscitation policy will be available to patients, families and carers and will be audited and monitored will reassure the public." [The Independent and Daily Telegraph, 5 September]


A doctor from Great Ormond Street hospital for children in London is examining the two Siamese twins, Jodie and Mary, today and will report back to the Court of Appeal tomorrow. The doctor in charge of the twins, referred to only as Doctor B, has revealed that Mary, the weaker twin, had been lying completely passively with her eyes closed, but now opens her right eye occasionally and has begun to suck, although she can't feed. John Kitchingman, a lawyer for the twins' parents, has said that if the present appeal fails, the case will be taken to the House of Lords or to the European Court of Human Rights. [Guardian Unlimited & BBC News Online, 5 August]


A judge in Massachusetts, USA, has decided that an unborn child should be given the same recognition as any other child under the state's child care and protection laws. Kenneth P Nasif, a judge at Attleboro Juvenile Court, used the laws to order a pregnant woman into a secure health facility after she refused to undergo a medical examination. The woman, Rebecca Corneau, is thought to be about eight months pregnant and belongs to a religious group which allegedly prohibits medical intervention to save the lives of newly born infants. [Washington Post, etc., 1 September; from Pro-Life Infonet]

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