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UK’s ‘Do Not Resuscitate’ Orders Drawing Anger

Wrongheaded public policies implemented in attempts to stem the spread of COVID-19 have caused more harm than good in many cases here in the United States. But in the United Kingdom, outrage is growing about a particularly pernicious public health directive: ‘Do Not Resuscitate’ orders for categories of patients with COVID.

These DNR orders first shocked the public across the UK back in December. A quality care organization revealed that certain nursing home residents with COVID were tagged with DNR orders due to other health conditions.

Do-not-resuscitate orders were wrongly allocated to some care home residents during the Covid-19 pandemic, causing potentially avoidable deaths, the first phase of a review by England’s Care Quality Commission has found.

The regulator warned that some of the “inappropriate” do not attempt cardiopulmonary resuscitation (DNACPR) notices applied in the spring may still be in place and called on all care providers to check with the person concerned that they consent.

In many cases, according to the Care Quality Commission (CQC), family members were unaware of these orders being placed on their relatives in the nursing homes.

The CQC received 40 submissions from the public, mostly about DNACPR orders that had been put in place without consulting with the person or their family. These included reports of all the residents of one care home being given a DNACPR notice, and of the notices routinely being applied to anyone infected with Covid.

Some people reported that they did not even know a DNACPR order had been placed on their relative until they were quite unwell.

Additionally, these blanket orders resulted in “avoidable” deaths, according to the CQC. These orders were placed during the first wave of COVID and CQC stated that overwhelming confusion may have led to the situation.

But fast forward to this week and the news has gotten even more disturbing. According to Mencap, a disability advocacy group in the UK, new blanket DNR orders during the second wave of COVID targeted patients with learning disabilities.

Edel Harris, Mencap’s chief executive, said: “Throughout the pandemic many people with a learning disability have faced shocking discrimination and obstacles to accessing healthcare, with inappropriate Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) notices put on their files and cuts made to their social care support.

“It’s unacceptable that within a group of people hit so hard by the pandemic, and who even before Covid died on average over 20 years younger than the general population, many are left feeling scared and wondering why they have been left out.

This population was supposed to have been fast-tracked for COVID vaccines as well. That’s because people with learning disabilities are at greater risk of death from COVID. In fact, disabled patients aged 18 to 34 are 30 times more likely to die of COVID than others in that age group.

NHS figures released last week show that in the five weeks since the third lockdown began, Covid-19 accounted for 65% of deaths of people with learning disabilities. Figures from the Office for National Statistics show that the rate for the general population was 39%, although the two statistics are drawn from different measurements.

However, Mencap notes that vaccinations of the disabled population are moving at a glacial pace despite the overwhelming risk.

“It’s unacceptable that within a group of people hit so hard by the pandemic, and who even before Covid died on average over 20 years younger than the general population, many are left feeling scared and wondering why they have been left out.

“The JCVI and government must act now to help save the lives of some of society’s most vulnerable people by urgently prioritising all people with a learning disability for the vaccine.”

Hopefully, elected and appointed officials in the United Kingdom, the United States, and around the world will do some serious soul searching when the crisis has ebbed. Many very bad decisions were made early on in the pandemic, but they appear to be continuing today.

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