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uk Death, bereavement & serious family crises hospital urgent call • end of life decisions • relative critically ill • family meeting hospital • treatment escalation plan • resuscitation decision • dnacpr discussion • respect form discussion • best interests meeting • mental capacity questions • health and welfare lpa • welfare power of attorney • last days of life • palliative care meeting • pressured to decide • what to ask the doctor • making decisions for parent • making decisions for partner • confused by medical terms • who can decide for patient

What to do if…
a hospital asks you to come in urgently to discuss end-of-life decisions for a relative

Short answer

Go in (or join by phone/video) and ask the team to explain, in plain language, what decision is needed today and why. Before agreeing to anything, ask whether your relative can still decide for themselves and whether there is any legal decision-maker already appointed.

Do not do these things

  • Do not sign forms or agree to major decisions while you feel rushed or confused—ask for a pause to understand what is being proposed.
  • Do not assume “next of kin” automatically means you can make decisions (authority depends on capacity and any appointed decision-maker).
  • Do not focus only on “CPR yes/no” without asking what it would mean for your relative in this specific situation.
  • Do not argue in the corridor or at the bedside—ask for a private room and a named senior clinician to lead the discussion.
  • Do not record staff without checking local policy/expectations; instead, take written notes.

What to do now

  1. Confirm the logistics and the urgency. Ask: “Is this a same-day decision? What happens if I arrive in 2 hours / tomorrow morning?” If you can’t get there fast, ask for a phone/video family meeting and the ward’s direct number.
  2. Ask who is leading the decision and what it’s called. Request the consultant (or the most senior doctor available) and/or the senior nurse in charge. Ask: “Is this about CPR/DNACPR, a treatment escalation plan (ReSPECT), intensive care, ventilation, feeding, antibiotics, or moving to comfort-focused care?”
  3. Ask the capacity question early (it changes everything). Say: “Does my relative currently have capacity to make this decision?”
    • If they have capacity, ask how the team will support them to decide (and how you can support them without speaking over them).
    • If they lack capacity, ask: “What is the best-interests process here, and who is the decision-maker under your local policy?”
  4. Check for existing documents or appointed decision-makers. Ask the team to check the records for:
    • a Health and Welfare Lasting Power of Attorney (LPA) (England/Wales) or (in Scotland) a welfare power of attorney
    • any Advance Decision to Refuse Treatment (ADRT) / advance decision
    • any existing DNACPR or ReSPECT form
      If you have paperwork at home, bring clear photos or ask someone to bring it.
  5. Bring the right information into the room. Quickly gather (even as a note on your phone):
    • your relative’s usual quality-of-life priorities (“what they would say matters most”)
    • any past expressed wishes about ICU, CPR, life support, severe disability, or dying in hospital
    • key baseline facts the team may not know (usual memory/mobility, recent changes)
  6. Use a simple question set to slow things down and get clarity. Ask:
    • “What is the most likely outcome with this treatment? What is the most likely outcome without it?”
    • “What are you most worried will happen in the next 24–72 hours?”
    • “Are you recommending for or against CPR/ICU, and why for this patient?”
    • “If we choose comfort-focused care, what symptoms will you treat and how will you keep them comfortable?”
  7. Ask for specialist support in the meeting. Request a palliative care team review (if not already involved) and ask whether a chaplain/spiritual care or family liaison/bereavement team can join if helpful.
  8. If there’s no family or you’re excluded, ask about advocacy. If your relative lacks capacity and has no appropriate family/friends to consult, ask whether an Independent Mental Capacity Advocate (IMCA) should be involved (England/Wales) and what the hospital will do next.
  9. If you’re worried they’re getting worse and you’re not being heard, ask about escalation routes. In England, ask staff how to activate Martha’s Rule (sometimes shown as a “Call for Concern”) if it’s available in that hospital.
  10. If there’s disagreement or you feel pressured, escalate calmly. Ask for:
  • a second senior review (another consultant if available)
  • the hospital’s patient advice service (for example PALS in England; other UK nations use different services)
  • an ethics or complex-case discussion if the hospital offers it
    If the dispute is serious and ongoing, ask what formal route the hospital uses (some cases may need legal advice and, in England/Wales, potentially the Court of Protection).

What can wait

  • You do not need to decide about funeral arrangements, registering the death, probate, or notifying wider family today.
  • You do not need to “get it perfectly right.” Your job now is to make sure decisions reflect your relative’s wishes/values as closely as possible and that you understand what is being recommended.
  • You do not need to resolve family conflict today—ask the team to identify one spokesperson for communication and schedule a follow-up meeting.

Important reassurance

Being called in urgently does not mean you are being asked to “choose life or death” on your own. Often, the team needs to explain what treatments can and can’t achieve, and to make sure care matches the person’s wishes and best interests. Feeling overwhelmed, tearful, numb, or angry in this meeting is a normal response.

Scope note

This is first-steps guidance for the hours around an urgent hospital meeting. Later decisions (legal authority, ongoing disputes, complex clinical choices) may need specialist support from the hospital team and, sometimes, independent legal advice.

Important note

This is general information, not legal or medical advice. End-of-life decision processes can differ across the UK (England/Wales, Scotland, Northern Ireland). If anything is unclear, ask the hospital to explain their local policy and the legal basis for who can decide.

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