Ethical guidance that is “even more clear” on the use of do not resuscitate orders will be soon be issued following controversy over their use at the beginning of the covid outbreak, the Scottish Government has pledged.

Scotland’s Minister for Older People Christina McKelvie told MSPs that guidance on making decisions about treatment and care had not changed during the pandemic – and she did not know why cases of DNR notices being imposed had emerged. 

But she acknowledged there had been “terrible examples” of people being told a DNR had been put in place for them by letters, phone calls – or even through text messages.

Giving evidence to Holyrood’s Equalities and Human Rights Committee, she said: “There is an updated ethical guidance coming out very, very soon I believe, which has been back and forward with stakeholders to get it absolutely right.

“I felt [this] was incredibly important – we needed to get this right, to reassure and maintain people’s human rights, maintain human dignity and not just scare the bejeezus out of people, as that is exactly what it was doing.”

MSPs on the committee have previously heard of cases where older people with conditions like Alzhiemer’s and dementia had DNR orders “slipped into their discharge notes” without any input from their families.

A national charity has also highlighted concerns that disabled people continue to fear they might be discriminated against when doctors decide who to treat.

At the beginning of the pandemic, there was widespread coverage of doctors asking or “imposing” DNR orders for residents of family members to sign, with the reasoning given they would not receive intensive care treatment anyway if the NHS was overwhelmed with virus cases.

When asked about where this idea had come from, Ms McKelvie said the “honest answer is we don’t know.”

“Our guidance to GPs and other health professionals didn’t change…the honest answer is we don’t know where this emerged from. It came along with the virus as part of a lot of the concerns that came up.”

But she said she had heard anecdotal evidence of cases through feedback from the Scottish Government advisory group the Older People’s Strategic Action Forum.

She said: “Quite a few of them had anecdotal evidence of they knew someone this had happened to, they got a phone call from the GPs receptionist or a letter dropped or an email.

“There was a terrible case in Aberdeen where someone got a text message.

“So it’s incredibly difficult to work out where this came from, but we have been absolutely clear on this – the DNR guidance has not changed.”

She said work was ongoing with the office of the Chief Medical Officer to find out why such actions had been taken.

She added: “Certainly as we emerge into recovery and renewal…there must be a lesson to be learned here about how a piece of information travels in a viral fashion and scares so many people like that when it didn’t need to.”

Sign up to our bulletin sent twice a week so you don’t miss out on the latest health and social care news.