Ontario Tribunal Penalizes Physician for Writing DNR without Consent

In Canada, Health Professional Appeal and Review Boards review disciplinary decisions from the Colleges of Physicians & Surgeons which are the equivalent of U.S. state medical boards. Over the past few weeks, these boards have published several judgments relating to medical futility.

At the end of August 2019, in J.D. v B.R., the Ontario HPARB affirmed a decision of the Ontario College to impose a remedial agreement on  physician who signed a DNR order without appropriate consent from the patient's DPAHC. 

A nurse had assessed the patient's capacity and determined that the patient wanted to be DNR. But given the patient's developmental delay, schizophrenia, and other conditions, the College determined that the physician should not have relied on the nurse even though physicians customarily sign plans of care prepared by nurses.

The complainant, the patient's brother, alleged that the sanction imposed by the College was too light. But the HPARB affirmed the remedial agreement as appropriate discipline.