Research published in the Journal of Medical Ethics has found that doctors in the UK are “less likely” to resuscitate patients in the aftermath of Covid-19; a significant number of doctors cited “resource limitation” as a contributing factor.
Doctors report they are more likely to brand patients with a “do not attempt cardiopulmonary resuscitation” (DNACPR) decision following the Covid-19 pandemic, the Journal of Medical Ethics has revealed.
The study aimed to assess whether the experience of the pandemic brought about a change in end-of-life care and DNACPR decisions in the UK – during the first wave of the pandemic, a third of UK Covid-19 patients received DNACPR notices.
Doctors of all grades, ages and expertise were surveyed in 2021. Over half of respondents said they were now less willing to resuscitate patients than they were before the pandemic began.
Contributory factors leading to DNACPRs included the “likely futility of CPR”, as well as the patient’s age; in the latter case, the importance of this factor rose from 50.5% (pre-Covid) to around 60% (as of 2021).
Despite these findings, the Journal of Medical Ethics reports that 59% of patients overall survived serious illness after receiving a DNACPR.
The most remarkable change reported by the study was the rise in doctors citing “resource limitation” as a justification for not resuscitating patients, up from 2.5% to 22.5%.
But the same study also found that the pandemic did not change doctors’ views about euthanasia and assisted suicide. One-third of respondents said they were very much opposed to any such proposed legislation.
However, the authors of the study stated that it was “yet to be determined” if these changes will “revert” or “evolve even further” beyond the initial impact of the pandemic.
“Unacceptable and inappropriate” DNACPR notices
In early 2021, a preliminary Care Quality Commission (CQC) report revealed “evidence of unacceptable and inappropriate” DNACPRs during the first wave of the pandemic, including notices served to patients with learning disabilities.
The Department of Health and Social Care responded by saying that “it is completely unacceptable for ‘do not attempt CPR’ decisions to be applied in a blanket fashion to any group of people. This has never been policy and we have taken action to prevent this from happening.”
A full CQC report later found “worrying variation” in patients’ experiences during hospitalisation due to Covid-19, including no consultations regarding DNACPRs. Over 100 patients may have had their right to life breached by such notices, as reported by SPUC at the time.
“A worrying trend that must be addressed”
SPUC’s Michael Robinson, Executive Director (Public Affairs and Legal Services), said: “This new study, following up the shocking CQC report in 2021, again highlights a worrying trend that must be addressed by the medical community as well as the Government.
“The recent pandemic has exposed and even precipitated an increasing disregard for the lives of vulnerable patients, especially the elderly and the disabled, as evidenced above. This is even more disturbing since efforts to legislate assisted suicide, which SPUC is opposing, are ongoing in the UK.
“Rather than ushering vulnerable patients into premature graves, legislators, ministers and MPs should be addressing the troubling ‘resource limitation’ that is affecting care decisions in our national health service.
“Serious and meaningful efforts must be made to redress this inimical ‘throwaway’ culture that is resulting in unnecessary deaths in our country.”