Do not Resuscitate: Not Our Choice to Make

Luke Murphy - Thoughts arising from the Scottish COVID Enquiry re: Healthcare

‘’Care’’: From Latin Caritas - via multiple paths and a word meaning Grief in a Germanic language, often translated as Love, and with regard to people, to will the good of others in practical ways, to value them.

Were we to walk a pier and at the end find a distressed Casandra locked in a glass box signaling for help, as someone is drowning in the water below, we may interject: “The sign here clearly states, swim at your own risk, so is it worth that artificial act of saving a human life?” A weak swimmer, says not at the risk of my life. That women locked in the box can’t help, and she signals to a floatation device placed there for just such an emergency. Perhaps the drowning is deliberate, and questions should therefore be asked by outsiders first. Is it a child drowning? Should we care about age or health? What if the glass entrapped were signaling not to intervene? What if the saved person were to die a week later? Would the lifesaving act have been a waste of effort?

As outsiders, do we have a duty of care to use the readily available technology to save a life?

Or can we forbear saving a life on the basis of the noise of our surroundings - from the glass box, signage by others, assumptions on the value of life of others with their challenges to fulfillment as we understand them?

Could layers be added to the scenario until we can watch feeling helpless, having convinced ourselves to be helpless, while others are allowed to die without help?

Stop, standing by and allowing someone to die is wrong. Caritas Christus urgent nos.

COVID seems to have been a spear through the heart and head of the health system that left a hole by which we can see a flaw.

Scotland is currently learning the lessons of COVID by way of a public enquiry. The evidence has not made any general reporting to date (covid19inquiry.scot).

Evidence given seems to have shown that patients were discharged to Care Homes without a COVID test – isn’t containing and treating infection the point of a hospital?

Evidence given seems to show that DNRs (Do Not Resuscitate), were put at bedhead of elderly or otherwise unwell patients without proper consent when the patients were admitted with COVID – isn’t saving patients with health difficulties the point of a hospital?

Evidence was given that end of life pathways were entered into via a 10 second telephone consultation – surely a decision of that sort, even in the pressured system, demands a measured face to face consultation?

In one case it seems that a patient under guardianship had a DNR with a forged signature of the guardian. The real guardian assured the enquiry she would NOT have signed the form.

It seems with this DNR we are not discussing complex high-risk procedures to painfully prolong a life against the wishes of dying patient –this is the currently available on the ward technology to save a life.

If I am on the pier, it is not my choice to make to deny a drowning man a flotation device. If I work in a hospital, it is not my choice to make to deny a patient basic health care. End of life pathways are difficult to navigate and as an outsider no judgment to condemn the participants in a system under stress is made here, rather we ask: “What signage and noise was Health operating under, and what honestly did transpire?”

The Scots have a way to go yet, but well-done Scotland to look into this hole through the heart and head of health care. What if Scotland be not alone? Did we enquire to show the inner workings of the institution Health Care under stress.

All sorts of issues arise that require careful consultation prior to denial of what level of care, the default must be to support life: if the Care in Health Care is standing by and watching a patient die, it is not Care.

Finally, our Health, is it Care?

See:
Rumble Dr Campell Care Home Deaths and Scotland comes clean.
Scottish COVID-19 inquiry    www.covid19inquiry.scot
Dr Adam Strachura AGE Scotland Re DNR CPR Witness Statement taken 15/9/23 on Teams 35 pages
Shelagh McColl K.C. Representing Bereaved Families