ReSPECT Forms

The ReSPECT form is a document detailing a person’s medical conditions and function, their wishes and priorities and uses this information to communicate recommendations regarding treatment and escalation plans. Completing these forms is a collaborative process resulting in a patient held document that can inform care in a variety of situations. The expectation is that the form will change over time to reflect changes in patients’ condition, treatment options and priorities.

When started early in the patient journey this should be a multi-event process; meaning dialogue can be opened, revisited, and updated over time. It can reflect the stage of disease a patient is in and their changing attitudes and priorities with regards to their care. It also opens dialogue with those important to the patient when present for these discussions.

A well completed ReSPECT form allows treating teams, who may not know the patient well, if at all, in an emergency. It serves as a form of advance care plan, as well as a place to document escalation plans, including resuscitation decisions.

It should be remembered that these forms are not legally binding, but rather a source of guidance and information. Any clinician with a rapport with the patient and their family can have these discussions, but only those with appropriate training should complete them.

Ultimately decisions about a patients’ resuscitation status, and to an extent which medical procedures and interventions are available, are the responsibility of the medical team. If there is a conflict between patient wishes and medical recommendations, while second opinions can and should be sought, legally the decision is a medical one, and a ReSPECT form could be completed despite this conflict.