Doctors consider universal do-not-resuscitate orders for coronavirus patients

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Ariana Eunjung Cha writing in The Washington Post:

‘Health-care providers are bound by oath — and in some states, by law — to do everything they can within the bounds of modern technology to save a patient’s life, absent an order, such as a DNR, to do otherwise. But as cases mount amid a national shortage of personal protective equipment, or PPE, hospitals are beginning to implement emergency measures that will either minimize, modify or completely stop the use of certain procedures on patients with covid-19….’

I can’t tell you how upset I am by this trend, although I assume it is being blown out of proportion in the service of sensationalism. It is much more likely that there will be some triaging around the futility of heroic measures on a case-by-case basis. And, let’s not kid ourselves — there always is and always has been in the practice of medicine, it is just not publicized or codified in an official change in hospital policy as is being discussed now. 

If all it took us to get to this point is a looming shortage of personal protective equipment for frontline healthcare workers, then place American industry on a wartime footing and make the damn PPE! Instead, leaping to a blanket override on the advanced directive wishes of patients, or families of patients, with a particular disease is such a wholesale abandonment of ethical principles at the first sign of adversity (yes, I know, not actually the first sign) that it makes a mockery of there being any ethical standards at all, makes a mockery of the supposedly altruistic motives that make the practice of medicine a worthwhile endeavor. Not only will it kill people en masse but it will kill the souls of those who participated for the rest of their careers. 

2 thoughts on “Doctors consider universal do-not-resuscitate orders for coronavirus patients

  1. grzz40 26 Mar 20 / 10.23 pm

    I think the right to stop living is inalienable, but I have no idea how to work around the oath MDs have to take. Comments welcome.

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  2. FmH 27 Mar 20 / 4.47 pm

    How are the two in conflict? “First doing no harm” entails, among other things, respecting patient autonomy, including the pt control over whether they live or die.

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