DNACPR and your LPA
Guidance from Estate Advisory Group
Written and legally reviewed by Ramani Gill TEP, Solicitor and private client practitioner·Last reviewed 13 August 2026
A DNACPR is a clinical recommendation, not a consent form. Attorneys must be consulted, and sometimes decide.
Who decides
- Clinicians decide whether CPR would be clinically futile; nobody can insist on treatment that will not work.
- Where CPR could work, the decision about whether it is in the donor's best interests must involve the donor, or their attorney if the donor lacks capacity.
- If the LPA gives attorneys power over life-sustaining treatment (option A), the attorney's refusal is legally decisive.
- Failing to consult an attorney is a common and challengeable failure.
Questions to ask
- What is the realistic chance of survival to discharge, and in what condition?
- Is this decision recorded on a ReSPECT form, and can I see it?
- Does the record show that I was consulted as attorney?
- Will the decision travel with the donor between hospital, home and care home?
A worked example
Consider Ahmed, whose son Karim holds a registered health and welfare LPA with option A for life-sustaining treatment. During a hospital admission, a junior doctor places a DNACPR notice on Ahmed's file after a brief conversation with a nurse, without contacting Karim. When Karim visits and finds out, he asks to see the ReSPECT form and points out that nobody consulted him despite the ward having a copy of the LPA on file. The consultant reviews the decision with Karim directly the same day, explains the clinical evidence around Ahmed's likely response to CPR, and the two of them reach a shared decision that is properly documented — a very different process from the one that happened by default the day before.
The difference between clinical futility and best interests
| Question | Who decides | Can the attorney overrule it? |
|---|---|---|
| Would CPR work at all? | Clinicians, on clinical evidence | No |
| Is CPR in the donor's best interests if it would work? | Attorney with option A, or clinicians consulting family if no attorney | Yes, if option A applies |
| Should the decision be reviewed as circumstances change? | Ongoing, by the clinical team | Attorney can request review at any time |
If you disagree
Escalate quickly and in writing
Ask for a second clinical opinion the same day, involve PALS, and where the disagreement is about best interests rather than clinical futility, the Court of Protection can be asked to decide urgently.
Common questions
Can I demand CPR for the donor?
No. You cannot require treatment clinicians judge would not work, but you are entitled to be consulted and to a clear explanation.
Does an advance decision cover CPR?
It can, if it refuses CPR explicitly, is witnessed and states it applies even if life is at risk. See advance decision or LPA.
What if no attorney has been appointed at all?
Clinicians must still consult anyone engaged in the donor's care, such as close family, but there is no single person with legal decision-making authority.
Should I carry a copy of the LPA to every hospital admission?
Yes. Giving the ward a certified copy on admission is the single most effective way to make sure you are consulted before decisions like this are made.
Read next
Where this fits
This page is part of Health and care decisions. The pages below take it further.
- Health & Welfare LPA
The LP1H: care, treatment decisions and life-sustaining treatment.
- Make an LPA online
The whole journey end to end: questions, documents, signing and registration.
Review and sources
Reviewed by Ramani Gill TEP, Solicitor and private client practitioner. Last reviewed 13 August 2026. We recheck fees, forms and Office of the Public Guardian guidance whenever they change — see our editorial policy.
Official sources
Most people make both LPAs
Property & Financial Affairs and Health & Welfare together cost £79 instead of £98 separately.
The Office of the Public Guardian charges a separate £92 to register each LPA.
This is general information about how Lasting Powers of Attorney work in England and Wales. It is not legal advice about your situation. What we do and do not do.
Published by Estate Advisory Group