Paramedic Response to ReSPECT DNAR — SCE Palliative Medicine MCQ

Correct answer: B — Respect the valid ReSPECT form, withhold CPR, and provide comfort and support to the family

When a valid ReSPECT form clearly indicating 'do not attempt CPR' is present at the scene, paramedics should respect this advance clinical directive without requiring doctor verification or family verbal confirmation (D is correct). Although DNAR forms are not contracts in law, NHS guidance and ambulance service policies consistently identify them as binding clinical communications that paramedics must follow. Paramedics themselves assess form validity and document the decision. Option C incorrectly assumes all arrests require CPR. Option E delays appropriate withholding of futile care unnecessarily. Option A initiates harmful treatment contrary to documented wishes. Option D imposes an unnecessary additional requirement (verbal family confirmation) not required by policy. In advanced heart failure with an established advance directive, respecting the form is the ethically and clinically appropriate response.

Reference: NHS: Do not attempt cardiopulmonary resuscitation (DNACPR) decisions; Leicester Leicestershire Rutland ReSPECT Policy 2024; South Central Ambulance Service Resuscitation Policy 2022. https://www.nhs.uk/tests-and-treatments/do-not-attempt-cardiopulmonary-resuscitation-dnacpr-decisions/