What Would You Do?
It is my experience that the do not transfer to hospital wish us related to not wanting to die in hospital. It is not about not having treatment, even in these circumstances treatment should and can be sought as Sheryl states. It is important that we seek solutions to the presenting problems and that can be done in a number of ways. The main thing is to respect the stated wishes of the individual whilst seeking to make them comfortable and even in the best case scenario facilitating recovery. Be there for the person reassure them, give them respect, compassion and do not compromise their dignity.
WWYD. Respecting Final Wishes ⚖️
A resident is living with a terminal illness and has a completed ReSPECT form clearly stating “Do not transfer to hospital.”
One morning , their condition changes. They develop a high temperature (39.7°C), become delirious, and are no longer able to communicate clearly. They appear very unwell and distressed.
Some staff feel strongly that an ambulance should be called, saying, “We can’t just leave them like this.” Others point to the ReSPECT form and say, “These were their wishes — we need to respect that.”
The family is not immediately available, and the situation feels urgent.
What would you do?
• Do you follow the documented wishes, even in a crisis?
• Do you override the plan and seek emergency treatment?
• Or do you look for another way to manage the situation in the moment?
When someone can no longer speak for themselves, how do we balance prior wishes, current risk, and our duty of care?