Published: May 16 2021 02:30 AM by Maeve Sheehan Families are considering legal action over claims that “do not resuscitate” (DNR) notices were imposed on nursing home residents during the Covid-19 pandemic without proper consultation with their loved ones. The concerns have been highlighted by Care Champions, an advocacy group for families of nursing home residents. A legal firm advising families suing or considering suing over a range of alleged failures is investigating the claims. Care Champions founder Majella Beattie said: “When Covid-19 hit, people received phone calls from doctors or directors of nursing and they were told a decision had been made about “do not resuscitate” in relation to their loved one. “They were told your mother is on the ‘do not resuscitate’ list or on a ‘do not transfer’ [to hospital] list.” The life-or-death decisions had already been made, Ms Beattie said. “Families were not being consulted and felt they had no say in it. “Families would often ring their own GP to try to argue their point but really got nowhere.” Since the Covid-19 pandemic, nursing homes were advised to have end-of-life care plans in place for all residents, and the Health Service Executive updated guidance on DNR notices. The guidelines require clinicians to discuss a DNR notice with the person concerned. If this is not possible, a discussion should be held with those close to them so clinicians can make the most appropriate decision for that person. While the decision is not a family’s to make, they must be consulted. Enda McGarrity, a solicitor with PA Duffy, confirmed his firm is advising a number of families on the alleged lack of consultation before DNR notices being placed on their older relative’s care plans, and has “significant concerns”. “Many of our clients have been particularly concerned about the lack of consultation with them as family members in relation to what may be a life-or-death decision for their loved one,” Mr McGarrity said. “In particular, we have identified clear issues, across many cases, in relation to the legal basis for DNRs, the appropriate imposition of protocols and their operation more generally.” Mr McGarrity said that without appropriate legislation, the decisions on DNR notices will “continue to be arbitrary” and not made on the basis of proper consultation with appropriate family members. “There is a distinct lack of legal certainty in this area, which itself is giving rise to legally questionable decision-making and on a wider basis raises serious concerns in relation to the State’s compliance with their positive obligations under Article 2 of the European Convention on Human Rights,” he said. The law firm is advising around 40 clients who are concerned about the treatment of their loved ones. Legal proceedings are expected to be issued against a number of nursing homes, alleging wrongful death and negligence. Sean Kyne, a Fine Gael senator from Galway, highlighted the case of a woman who was treated for cancer and had a DNR order placed on her file in ICU with Covid-19. He told the Seanad in November that the family were told by a nurse while the woman was on a ventilator in ICU. There had been no discussion or consultation with either the woman or her family beforehand. Similar concerns over DNR notices have recently been investigated in the UK by the British health watchdog. The Care Quality Commission identified 500 cases in which DNR decisions may have breached the person’s human rights. The decisions had not been agreed with the person or their family. Nursing homes suffered the worst of the pandemic, with more than 2,000 residents dying of or with Covid-19 in Ireland since outbreaks began last year. The health watchdog Hiqa received 400 notifications on concerns about the treatment of residents in nursing homes.