DNRs, Age and Class

Age UK and Independent Age, two charities concerned with the care of the elderly, have warned against the increasing use of pressure for elderly people to sign Do Not Resuscitate (DNR ) forms. It has created fear and anxiety among the elderly and a feeling that they are not wanted and are superfluous to society.

As the statement from the charities says: “Difficult and painful decisions will need to be made in the weeks ahead, but these must be made on a case-by-case basis, taking account of the risks and benefits, and people’s own wishes, through honest discussions between patients, doctors and families. We do not under-estimate the significant pressures being faced by all staff working across our health and social care sectors at this difficult time, but it is crucial that we continue to protect people’s fundamental human rights. It would be completely unacceptable to abandon these rights in favour of taking blanket, discriminatory decisions.”

An 86 year old woman in Scotland was recently pressurised by her GP surgery to sign such a form. In Brighton and Hove, a Clinical Commissioning Group (CCG) wrote to care homes for elderly people. It stated that: “frail elderly people do not respond to the sort of intensive treatment required for the lung complications of coronavirus… We may therefore recommend that in the event of coronavirus infection, hospital admission is undesirable.” It instructed care homes to “check they have resuscitation orders on every patient”. In other words those in care homes for the elderly should be left to die.

There have been reports of similar incidents in Leeds and Wales.

It is not just the elderly who are under threat from the DNRs. A Welsh GP surgery sent out a letter to all high risk coronavirus patients and included those with “incurable cancer”, “neurological conditions” and “untreatable heart and lung conditions”. The mention of neurological conditions is particularly worrying, as government guidelines include Parkinson’s disease, motor neurone disease, multiple sclerosis, cerebral palsy and those with learning disabilities.

Obviously those suffering from such dire diseases as motor neurone disease would actually experience a deterioration in quality of life if a resuscitation was attempted. But those with some of the other conditions, including those with learning disabilities, have conditions that are not life threatening in the short and medium term. What is particularly disturbing is that people suffering from such conditions are amalgamated with those with terminal complaints. This reeks of the eugenics we referred to in our article, Age, Herd Immunity and Coronavirus.

The health services are under massive pressure because of the many years of cutbacks by Conservative, Labour and Conservative-LibDem coalition governments. So the logic behind these letters is that the NHS cannot cope with many more chronically ill people. Whatever the logic, these letters are appalling and disturbing.

We should remember that it is unlikely that DNR request letters have been sent to Queen Elizabeth, Prince Philip (both in their nineties) Prince Charles (over seventy) or any of the millionaires and politicians seen as elderly. These decisions are influenced by class. If you are poor and old/have learning disabilities etc., you are deemed as expendable, and hang the stress this puts on you and your family. If you are rich and powerful, no such qualifications apply.

This further emphasises the need to move towards a society that looks after and respects the elderly, those with chronic diseases and those with learning disabilities. The austerity programmes of the last few decades are now breeding obscenities like these DNR request letters, the huge pressure on over-worked and ill-equipped health workers, patients in chronic conditions suffering and dying in corridors.

No Going Back!