19.02.2021 – ‘Do not resuscitate’ notices given to Covid patients with learning disabilities

19.02.2021 – ‘Do not resuscitate’ notices given to Covid patients with learning disabilities

People in the UK with learning disabilities have had ‘do not resuscitate’ orders placed on their medical charts, to be adhered to in the event they become seriously ill during the Covid-19 pandemic.

The Care Quality Commission (CQC) has found “evidence of unacceptable and inappropriate” use of these orders being activated after the outbreak of Covid-19.

An interim report from the CQC states that the “blanket and inappropriate” use of ‘do not resuscitate’ orders could have had an impact, including potentially unavoidable death, on older people and disabled people living in care homes, including those with physical and sensory impairments, people with a learning disability or cognitive impairments such as dementia.

Mencap, a UK charity that works to improve the lives of people with learning disabilities has said it received reports in recent months from people with learning disabilities that they had been told they would not be resuscitated if they were taken ill with Covid. The Guardian newspaper and other media outlets have drawn attention to the issue in recent days.

The frightening practices the CQC brought to light in the UK raises questions about how ‘do not resuscitate’ orders are also being used in Ireland since the outbreak of Covid.

Last year, in the early stages of the Covid outbreak, Peter Fitzpatrick TD raised the issue in the Dáil. He referenced a HIQA report from a few years back that revealed the fact that “do not resuscitate” orders were written on the medical charts of patients in some nursing homes in Ireland without the consent of residents or the knowledge of next of kin.

Addressing the Minister for Health in the Dáil at the time, Deputy Fitzpatrick said: “I have nothing but respect and admiration for the heroic healthcare workers who have been standing in the firing line in recent months to help save the lives of others. They are true heroes. I want to put on record my praise and gratitude to them in the strongest possible way. However, as a society we cannot allow the situation to continue whereby families feel totally overwhelmed when confronted with issues such as “do not resuscitate” orders. In some cases, they believe that doctors are making judgments on whether their loved one should receive additional medical care not based on clinical considerations but on quality of life and other non-medical considerations.”

Deputy Fitzpatrick sought clarification from the Minister for Health on how precisely ‘do not resuscitate’ orders are being used in Ireland. To date, it remains unclear how precisely the orders are being applied.