Navigating DNACPR decisions: a qualitative study of DNACPR factor variability and implementation among NHS Doctors

Our findings highlight a clear need for a more robust and equitable framework for these critical conversations, whilst also enabling clinicians to be able to make case-by-case decisions. The development of a national DNAPR policy that integrates evidence-based data may help doctors select and weigh factors appropriately, and provide a framework for the initiation of DNACPR discussions. However, such a policy must nevertheless be sufficiently flexible to permit doctors the autonomy required to make nuanced decisions on the basis of a range of patient-specific contextual assessments. Our key recommendation, therefore, is that clinicians should be supported not only by improved procedures and processes, but also by confidence that their professional judgement is rooted in the most current clinical evidence.