MY heart goes out to Mrs Pat Pilling and her family following the death of her husband Milton, who was reported to have had a "Do Not Resuscitate" (DNR) order placed upon him (Bury Times, May 26).

As a nurse involved in the care of critically-ill patients, I felt compelled to write to dispel a few myths.

First, a heart attack is not the same as a cardiac arrest. As far as I am aware, patients suffering from a heart attack will be given the appropriate treatment, unless that treatment is unsuitable for the person due to allergy or other medical contra-indications. Second, a DNR order relates to the condition of cardiac arrest (in the event of a cardiac arrest the patient will not be resuscitated). According to the Resuscitation Council (UK) "A hospital . . . should only attempt to resuscitate those who have a reasonable chance of survival. The morale and enthusiasm of the team will decline rapidly if their attempts continue to fail or if the patients are resuscitated only to die . . . shortly afterwards".

Doctors make the decision not to resuscitate based on the patient's quality of life before the illness; their medical history; their expected quality of life should recovery take place; and the likelihood of resuscitation being successful.

While the views of the relatives are considered, it must be remembered that most people in this situation are under severe emotional strain and cannot face losing their loved one. Regrettably, resuscitation techniques are very limited and the outcome is usually dependent on the cause of the cardiac arrest.

While Mrs Pilling is correct to say that the doctor must not "play God", they do make an extremely difficult decision with the benefit of experience. An upsetting situation could have been avoided had Mrs Pilling been better informed of the reasons for the decision.

MRS NINA OAKLEY,

Dunkirk Road, Whitefield.