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Edwin's avatar

Do not resuscitate

Jack King

Many decades ago, doctors agreed that it was wrong to resuscitate patients who were in severe pain and who were terminally ill (or ‘terminally, terminally ill’ as is preferred these days). Before the introduction of the ‘Do Not Resuscitate’ (DNR) protocol it was common for severely ill patients to be dragged back to life time and time again. Whenever such a patient stopped breathing (and effectively died) a ‘crash team’ would be mobilised. Doctors would run to the ward with masses of equipment and the patient would be injected, intubated and (literally) shocked back to life. As a young hospital doctor I was accustomed to seeing patients repeatedly dragged back to life from the brink of death. No one really thought of just letting someone die. If and when a patient died we considered that we had failed – however old and ill they were.

That was then.

Today, the DNR protocol has been expanded and my mailbox has, for years been full of stories of patients complaining of being asked to sign ‘Do Not Resuscitate Forms or having Do Not Resuscitate forms signed on their behalf. (These are known as DNR forms or DNAR forms – for Do Not Attempt Resuscitation.)

DNR notices are only inches away from euthanasia and could, perhaps, be best described as ‘passive euthanasia’. The doctor doesn’t actually do anything to kill the patient. But he doesn’t do what he could do to stop them dying.

In recent years, GPs all over the world have been contacting their elderly patients, and those with chronic health disorders, and asking them two questions. Even perfectly healthy patients have been approached if they have reached a certain age. (The age at which doctors consider a patient not worth saving varies but is usually around 70.)

‘Are you happy for us to put a DNR on your file?’

And

'Are you happy for us to put on your file a note that you won’t be admitted to hospital if you become unwell?’

Note the clever wording, designed to elicit a positive response. It’s the sort of trickery used by crooked pollsters and insurance salesmen – knowing what answer they want and shading the question in such a way as to ensure that they get it.

One medical practice sent out a letter to a home catering for autistic adults saying that the carers should have plans to prevent their patients being resuscitated if they became critically ill.

Other GPs sent out similar letters to establishments caring for the elderly and the disabled. Blanket decisions were made for care homes and residential homes caring for patients with learning difficulties.

A 51-year-old man with Down’s Syndrome was given a DNR because of his disability, and instructions were left that there was to be no attempt to resuscitate him if he had a cardiac arrest or a respiratory arrest. No consent form was signed and there was no agreement with the patient or his relatives. The Medical Director for the relevant part of Britain’s National Health Service said that their policy complied fully with national guidelines from professional bodies.

The boss of a large charity said that they believe that DNR orders were frequently being placed on patients with learning disabilities – without the knowledge and agreement of their families.

This was, of course, illegal.

Back in 2015, the High Court in the UK ruled that carers for patients with mental illnesses should be consulted before DNR notices were applied.

But the coronavirus nonsense resulted in a flood of such cases.

A man in his 50s, with sight loss, was issued with a DNR notice giving ‘blindness and severe learning disabilities’ as the reason.

A man with epilepsy was issued with a DNR notice, and at the end of March this year a GPs’ surgery in Wales urged high risk patients to complete a DNR form if they contracted the coronavirus. The letter said, ‘you are unlikely to receive hospital admission’.

A woman in Bristol received a phone call from her GP asking if it were OK for her medical records to be updated to say that if she contracted the coronavirus she wouldn’t go to hospital or receive any medical treatment.

In the UK, the National Institute for Health and Care Excellence, known as NICE, is the official advisory body to the health care world. And a NICE ruling is utterly crucial.

NICE classified people in nine categories. If you are in category 1 then you are very fit. If you are in category 9 then you are terminally ill (though, when it suits them NHS staff sometimes devise another category of ‘terminally, terminally ill’).

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Ernie Boxall's avatar

What a pity that you got so much right about the coming elections in England (Scotland, Wales and Northern Ireland left the union years ago) and yet so wrong about Israel/Hamas war.

I'd direct you to talk to the many Israeli Arabs who are, at this very moment, intent on wiping out the scurge of Hamas.

Even as a gentile I have some skin in the game having volunteered to go to Israel two days into the Yom Kippur War of 73 and realising how close the Syrian tanks came to rolling through the Golan Heights.

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