Editor @Salann

There’s a growing disquiet just now after news that GP surgeries in Scotland, England and Wales have been phoning round elderly patients hoping that they’ll agree not to be resuscitated, should they be struck down by COVID-19.

The logic, grim though it may be, is that if such patients agree not to have CPR this will save overstretched medics time and resources at a time when reserves of both these commodities are low.

Today I heard that my elderly neighbours, back home in the North of Scotland, had received one such phone call from the surgery down the road.

The wife, Pat, told me that a nurse telephoned to ask, in hasty tones, if her 80-year-old husband Donald would agree to a Do Not Resuscitate (DNR) order right then, over the phone.

Needless to say Pat was taken aback at the question. Could she make a spur-of-the-moment decision about the end-of-life care of her husband? Should she?

Pat said: “She was rushing through it. We were taken aback at getting a call like this and felt pressurised into making a decision. It should be discussed with the wider family. The nurse wanted an answer there and then.”

She went on to describe the nurse as “quite blunt” (putting it mildly)  and “in a hurry to get all the forms filled in”.

Donald, though still spritely and with a wicked sense of humour, is in the early throes of dementia and gets stressed when having to think too much. A question of such gravity caused him significant anxiety.

Today I also heard about another elderly resident who was asked, again over the phone, if they would consider staying at home to die if they contracted COVID-19, rather than filling up space in hospital.

There is only one word for these incidents and that is ‘shameful’. 

Elderly people deserve more support and compassion from medics, precisely because they are more vulnerable. They should not be considered dispensable. And they certainly shouldn’t be questioned in this crass way, like they are merely part of some administrative box-ticking exercise.

These surgeries are asking deep questions about people’s lives. About decision that will affect them profoundly, and lastingly.

It’s time for the medical establishment to row back from this obvious knee-jerk reaction to the COVID-19 crisis and uphold the dignity of all patients equally.

Historically, all doctors were required to swear the Hippocratic Oath. This was revised numerous times over the centuries and today, one of the closest oaths is the ‘Physician’s Pledge’ of the World Medical Association.

Perhaps medics should recite these words again.

The Physician’s Pledge

AS A MEMBER OF THE MEDICAL PROFESSION:

I SOLEMNLY PLEDGE to dedicate my life to the service of humanity;

THE HEALTH AND WELL-BEING OF MY PATIENT will be my first consideration;

I WILL RESPECT the autonomy and dignity of my patient;

I WILL MAINTAIN the utmost respect for human life;

I WILL NOT PERMIT considerations of age, disease or disability, creed, ethnic origin, gender, nationality, political affiliation, race, sexual orientation, social standing or any other factor to intervene between my duty and my patient;

I WILL RESPECT the secrets that are confided in me, even after the patient has died;

I WILL PRACTISE my profession with conscience and dignity and in accordance with good medical practice;

I WILL FOSTER the honour and noble traditions of the medical profession;

I WILL GIVE to my teachers, colleagues, and students the respect and gratitude that is their due;

I WILL SHARE my medical knowledge for the benefit of the patient and the advancement of healthcare;

I WILL ATTEND TO my own health, well-being, and abilities in order to provide care of the highest standard;

I WILL NOT USE my medical knowledge to violate human rights and civil liberties, even under threat;

I MAKE THESE PROMISES solemnly, freely, and upon my honour.