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43 A systematic review and critical discourse analysis (CDA) of the reporting of do not attempt cardiopulmonary resuscitation (DNACPR) decisions in UK national broadsheet and tabloid newspapers
  1. Alice E Gray,
  2. Katherine E Sleeman and
  3. Katherine Bristowe
  1. Cicely Saunders Institute, King's College London, UK

Abstract

Introduction The Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decision is a routine aspect of medical care, but there can be misunderstandings among patients and the public relating to these decisions. The aim of this study was to identify how DNACPR decisions are portrayed in print media, and understand how this contributes to public opinion.

Methods A systematic review using three databases (Newsbank’s Access World News, ‘Factiva’ database and ‘Daily Mail Historical Archive’) was conducted, for articles published between January 2000 and September 2016. A Critical Discourse Analysis was carried out at three levels: textual (micro); discursive practice (meso); sociocultural practice (macro).

Results 116 articles were identified, comprising a corpus of 68082 words. Textual analysis demonstrated two opposing portrayals: the vulnerable patient requiring life saving through CPR, and the medical body failing in their duty to keep the patient alive. Analysis of discursive practice found the power of truth-telling lay with patients and families who associated DNACPR with poor-quality care and concealment suspicions. Sociocultural analysis found DNACPR decisions were incorporated into wider end of life care criticisms.

Conclusions This study demonstrates an overwhelmingly negative and inaccurate portrayal of DNACPR within print media, contributing to the public’s mistrust of professionals and their decision-making power. A DNACPR decision awareness campaign to communicate realities about DNACPR decisions more effectively with the public is urgently needed. Access to accurate information will improve understanding between the public and clinicians.

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