Antrim Area Hospital: Man says human rights 'violated' by DNR order

A County Antrim man who was unaware that a "do not resuscitate" (DNR) order had been placed on his medical file has said he feels his human rights have been violated.

Neill Birnie is paralysed from the neck down as a result of secondary progressive multiple sclerosis.

In 2014, he was admitted to Antrim Area Hospital three times.

He said that following the first admission he discovered a DNR order had been placed on his medical file.

According to Mr Birnie, the order had been placed on his record without his knowledge.

The 48-year-old is unable to talk and spoke to me via a head-operated computer.

"A consultant told me that I had gone through enough and I had to face the facts.

"He went on to say that he'd consulted with others and that they both thought that a DNR notice should be placed on my admission file," said Mr Birnie.

He told the BBC that at no time did either he or his sister grant permission for a DNR notice to be placed on his file. While he survived the first bout of pneumonia, he said he discovered when admitted for a second time that the DNR notice had not been removed.

"What some of the doctors did was life-threatening and mentally cruel. I felt I had been tossed to the one side, I had no feelings of self worth," added Mr Birnie.

Several months after the incident, Mr Birnie made an official complaint to the Northern Health and Social Care Trust.

In a letter to Mr Birnie dated October 2015 and seen by the BBC, the trust explained that as he was so unwell they had spoken to his sister.

The trust also said that if the infection had caused his heart to stop, medical staff would not have been able to bring him back and that attempts at cardio respiratory resuscitation would not have been in his best interests.

However, Mr Birnie said he does not accept that a DNR notice was placed on his file in advance of him being admitted without his or his sister's consent.

In a statement to the BBC, a spokesperson for the Northern Health Trust confirmed that a DNR notice was placed on Mr Birnie's file in January 2014, but not before a conversation had taken place with their patient.

"The decision to implement a DNR is a medical one, which is taken in cases where medical professionals feel that if a person's medical condition at that time causes their heart to stop, resuscitation attempts would be futile and therefore not in their best interests in providing a dignified death.

"This was discussed with Mr Birnie initially and was put in place following a conversation with his next of kin who indicated that they had talked it over with Mr Birnie and agreed with the decision taken," the statement said.

"A DNR notice is reviewed and, if felt appropriate, renewed on a daily basis. There is currently no DNR on Mr Birnie's file and his treatment remains unaffected."

A DNR notice is an extremely sensitive issue. Often the subject can arise when a person least expects it or is not in a position to make a rational judgement.

The order means medical staff will not attempt to bring the patient back to life if they stop breathing or their heart stops.

The decision to use one is ultimately a doctor's, but official guidelines from the British Medical Association (BMA) state medical staff have a duty to discuss it with relatives wherever possible.

The problem for medical staff is that sometimes the conversation between doctor and the patient or family may not take place in time.

The usual circumstances in which it is appropriate not to resuscitate are when it will not restart the heart or breathing; when there is no benefit to the patient; and when the benefits are outweighed by the burdens.

The guidelines also say that it should only be issued after discussions with the patient or family.

However, according to Neill Birnie that did not happen.

As a quadriplegic who requires 24-hour care via the computer, he told me he is still a human being with feelings: "The lights are still on and I am definitely at home."

Via his voice-activated computer, he told a rude joke that made me laugh. He smiled through his eyes.

At times, there were tears in his eyes.

Earlier this year, a study by the Royal College of Physicians in England found one in five families was not consulted when doctors had decided not to revive their relative.

The study was taken from just over 9,000 dying patients.