A study has found that the COVID-19 pandemic has led to an unwillingness on the part of doctors to resuscitate patients, with more people than ever receiving “do not attempt cardiopulmonary resuscitation” (DNACPR) orders than before the pandemic.
Dr. Benjamin Kah Wai Chang, the author of the study, told Express that at the beginning of the pandemic, the increase in DNACPRs was due to demand issues. “[T]he BMA advised clinicians that in the event of NHS resources becoming unable to meet demand, resource allocation decisions should follow a utilitarian ethic,” he said. “However, what is clear from our results is that for a significant proportion of clinicians, resource limitation continued to factor into clinical decision-making – even when pressures on NHS resources returned to near-normal levels.”
He added, “What is yet to be determined is whether these changes will now stay the same indefinitely, revert back to pre-pandemic practices, or evolve even further.”
In the study, which was published in the BMJ Journal of Medical Ethics, more than half of 231 doctors surveyed said they were making more patients DNACPR than before the pandemic. Only 2% said they were giving DNACPRs to fewer patients than before the pandemic. The doctors were also asked their reasons for the DNACPRs, with the most common reasons cited being the likely futility of CPR, and patient comorbidities, as well as patient age and resource limitations.
READ: SHOCK: ‘Do not resuscitate’ orders offered to teens with autism and learning disabilities
The concerning information echoes what was already uncovered during the pandemic. A report from the United Kingdom’s Care Quality Commission (CQC) found that DNACPRs were being issued to people with intellectual disabilities, without consulting the person or their family first. The complaints regarding these inappropriate DNACPRs rose by 300%, and care homes were regularly putting them in place once residents tested positive for COVID-19, though some went even further; one care home was found to have put a DNACPR in place for every resident. This includes children with disabilities like autism and Down syndrome.
A report from Public Health England found that the death rate from COVID-19 for individuals with learning disabilities in the 18-34 age group was 30 times higher than for their neurotypical peers.
With the news of this study, some are concerned these actions from the height of the pandemic will have permanent repercussions for vulnerable patients.
“We know that during the early stages of the pandemic, when hospitals generally and ICUs especially were under huge pressure, some older people were unable to access the treatment they wanted and required,” Caroline Abrams, of Age UK, said. “That must not be allowed to become ‘the new normal’: older people have the same rights to help from the NHS as any one else and doctors’ judgments must be objective and based on clinical need.”
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