Thursday, 21 May 2020
Covid-19 (Health): Statements
Peter Fitzpatrick (Louth, Independent)
I want to raise another important issue regarding the recent handling of the Covid-19 outbreak, that is, the "do not resuscitate" order. Most families are totally unprepared when confronted with the discussion around a "do not resuscitate" order when a loved one becomes gravely ill.
I am aware the HSE guidelines place an obligation on healthcare providers to consult with patients where possible or, alternatively, with family members regarding the issue of "do not resuscitate" orders. However, the reality is that many families are too overwhelmed when they are faced with this situation to be able to make a fully informed decision on the spur of the moment. I know for a fact that many families who have been in this heartbreaking and terrible situation could not fully grasp what they were being asked and were 100% dependent on the information given to them by those caring for their loved ones. They are now left with questions as to whether they did enough to save their loved ones and the answer, of course, is that they did. Any of us can only act on the information we are given. My concern is that patients and families are not significantly informed on the matter until it lands at their door.
A HIQA report from a number of years back referred to the fact that "do not resuscitate" orders were written on the medical charts of patients in some nursing homes without the consent or knowledge of the next of kin. This is an unbelievably serious matter and the only response to this is more openness and public debate on the issue. I am aware that many families were put in impossible situations in recent weeks, with a feeling of being kept in the dark and feeling overwhelmed about what they were confronted with regarding their loved ones who became gravely ill. In many cases, sadly, they died. I stress that I am not singling out any specific nursing home. However, the area of "do not resuscitate" orders needs urgent attention.
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.
The lack of a proper public consultation on these issues before the Covid-19 outbreak has placed us in this impossible situation. It has caused huge heartbreak and even despair for many families. The answer required is not an uncontrolled discussion on medical ethics but one that openly embraces the view of those who have been left out of the debate and sidelined in recent years. I call on the Minister to address this as a matter of urgency.