A GP surgery in South Wales has apologised for a letter sent to patients with serious health conditions asking them to complete a ‘Do Not Resuscitate’ form in case their conditions deteriorated due to coronavirus.
The letter from Llynfi Surgery in Maesteg, near Port Talbot, took the opportunity to inform people with life-limiting illnesses, who are at much higher risk from Covid-19, that they were unlikely to be offered hospital admission and ‘certainly will not be offered a ventilator bed’.
It said that completing the form indicating they would not want to be resuscitated would have several benefits, including ‘your GP and more importantly your friends and family will know not to call 999’ and ‘scarce ambulance resources can be targeted to the young and fit who have a greater chance’.
Subsequently Cwm Taf Morgannwg University Health Board said: ‘The surgery have been made aware that the letter has caused upset to some of the patients who received it. This was not their intent and they apologise for any distress caused.’
However it turns out this Welsh practice is not alone in trying to persuade patients to volunteer to die without NHS help or support. TCW has evidence of similar letters sent in Edinburgh to the homes of dementia patients, pressuring spouses/carers not just to agree to DNRs but to agree to managing end-of-life nursing at home themselves.
Others have been busy too. An NHS document sent to GPs by the Sussex Clinical Commissioning Group advised against sending elderly care home residents to hospital if they have Covid-19. It provided a suggested script for GPs to use in conversations with residents and families, part of which says ‘frail elderly people do not respond to the sort of intensive treatment required for the lung complications of coronavirus and indeed the risk of hospital admission may be to exacerbate pain and suffering’. It goes on: ‘We may therefore recommend that in the event of coronavirus infection, hospital admission is undesirable.’
Peter Kyle, Labour MP for Hove, reported that Do Not Resuscitate notices are being used ‘carte blanche’ in care homes – that elderly and frail residents are being rushed to make decisions about their end-of-life care. He said that one care home administered DNR notices to 16 out of 26 residents in one day.
All this comes amongst heavy-handed hints that we must start to talk about dying.
It may be too late to erase from the minds of these vulnerable patients instructed to self-isolate for the sake of the NHS the spectre of the Grim Reaper getting to work while the Good Samaritan attends to people who are younger and stronger. But it is surely not too late for the young to question this latest application of Darwinism hiding under the guise of ‘protecting our NHS’ from the sick, the very people it was set up to help, for what it is. And that this epidemic is no excuse for abandoning medical ethics or the Hippocratic Oath.
They might consider that the Queen is approaching 94 and that the Duke of Edinburgh is approaching 99. Should they be asked to complete a ‘Do Not Resuscitate’ form, or be lectured on the burden they would place on the NHS should they call on their services rather than dying without the dignity of care in their own homes? I hope not. Why should it be different for the rest of us?
We need to ask which category of society will be next in line to be unworthy of NHS services? The severely disabled, Down’s children, the mentally ill, those with cancer?
It is ironic that an NHS unable to care for the sick still finds time, staff and resources to tell people not to use it, nor has it been able to ensure the protection of its front-line staff expected to treat coronavirus patients. Several have now died. Does it really deserve the constant praise that the Prime Minister and celebrities encourage us to repeat in defiance of the evidence?
The NHS does not always perform well, its standards of care revealed in one damning report after another in recent years, such as here and here.
Whorlton Hall, which the BBC filmed mistreating autistic residents, stands as but one example of the appalling state of mental health care in this country.
Despite all these failings, both the Conservative and Labour parties are committed to defending ‘our NHS’ come what may, and is weaponising this to the extent that anything but loud praise is taken as a sign that people are lacking in compassion.
Yet an institution that warns the weakest and the sick to stay away, that pushes the message portraying the elderly not just as a ‘burden’, but as dispensable, is long overdue for reform.
The government’s big coronavirus message, plastered everywhere, is ‘Stay home to protect the NHS’. We must ‘protect our NHS’ from – us. Maybe we should all martyr our lives to it?
