Do Not Resuscitate and COVID-19 – Whose Life Matters?

We are now in a time where the word ‘unprecedented’ is being used very often. Each day we are seeing another practice, action, decision or policy as part of the fight against Covid-19 which seeks to protect life, but which in fact reveals some shocking attitudes about whose life counts and whose does not.

Preserving Life

There is no doubt that the NHS and medical practitioners throughout the UK and Ireland are working relentlessly to preserve life in the wake of this Covid-19 pandemic. However, there have been reports on social media and in the news of older people and those with learning disabilities and having Do Not Resuscitate (DNR) orders applied to them, with little advice or consultation. This information has come from care providers in care homes across the UK who have reported that they have been contacted by GPs to say that they have deemed the people they support, who have learning disabilities, and other complex needs, should all be DNR. There was no mention of consultation with families or best interests assessments. According to a report by the Guardian, residents in care homes in various locations across the UK have had “do not attempt resuscitation” (DNAR) notices applied to their care plans during the coronavirus outbreak without proper consultation with them or their families. In one care home, after a visit from a GP, all 20 residents had DNAR notices attached to their individual care plans. NICE Guidance on how doctors should decide who could get emergency care during the coronavirus crisis was rewritten after complaints that the initial guidelines suggested that disabled people could be denied treatment. Sadly, this discrimination is not new. Those that work with people with learning disabilities, their families, carers, and groups, see this every day. From a lack of access to basic services such as education and housing, to shorter life expectancy and avoidable deaths when in the hands of health and social care agencies. Older people also experience similar discrimination issues, but the covid-19 situation is throwing this into even sharper relief.

Medical Judgement and Covid-19

Unfortunately, the stark reality is that our healthcare resources are not infinite. The NHS, and social care have limited resources and this has been made more extreme by Covid-19. Medically, very difficult decisions will need to be made, about who will get treatment and who will not. When these decisions are made not on the basis of medical judgement, but rather on the basis of ingrained, discriminatory attitudes about whose life has more value, that is when we have a societal problem and that is when we need to fall back on the safety net provided by the Human Rights Act.

Human Rights Act

Human rights, set down internationally, and put into our domestic law through the Human Rights Act, belong to every single person within the EU, whether they have learning disabilities or not, whether they are over a certain age or not and whether they fall into Covid-19 vulnerability or not. Importantly, Article 2 of the Human Rights Act protects an individual’s right to life. This means that nobody, including the Government, can try to end your life. The Government’s analysis of the recent coronavirus legislation flags the need for action to protect the right to life in the context of the pandemic. It is vital that medical professionals make lawful, legitimate and proportionate decisions which are non-discriminatory; decisions which can be defended in this time of emergency, and which ensure the future post-pandemic world still values human dignity.