In some medical circumstances, it is decided that a person should not receive CPR treatment. This is ordinarily when such attempts would be futile or would cause a person's death to be unnecessarily traumatic or undignified. Such decisions (do not attempt CPR (DNACPR)) should be discussed with the individual concerned or their representatives if the individual lacks capacity. Clearly, these decisions and discussions are of profound importance to those individuals and their loved ones.
During the first wave of the coronavirus pandemic, it became clear that it was being decided that whole groups of people, often in care homes, were being told that should they contract coronavirus attempts at CPR would not take place. This was examined by the CQC, who found, in the first phase of a review on the subject, that "evidence of unacceptable and inappropriate DNACPRs being made at the start of the pandemic,” and that this may have caused “potentially avoidable death”.
By the nature of the individuals involved, the elderly and those with a learning disability, this issue affects the most vulnerable members of society. It has now been reported, that despite the condemnation of this practice, that people with a learning disability were still being told that if they were taken ill with Covid-19 they would not be resuscitated.
This continuing issue is completely shocking and as a society, we must do better. To arbitrarily decide a person should not receive all appropriate treatment deprives those individuals of proper care, the opportunity to receive all possible treatment, where that is the right approach for the individual, and significantly infringes their rights. The wider impact on their families and loved ones should not be discounted.
This news must be set in the context of people with a learning disability generally having poorer outcomes in terms of the healthcare they receive. In the fourth annual Learning Disabilities Mortality Review (LeDer) Programme report in 2019, it was found that on average people with a learning disability died between 22 and 27 years sooner than the general population.
It can only be hoped that these practices are being stamped out and urgent steps are being taken to ensure that all DNACPR notices are being properly and lawfully dealt with so as to prevent any further avoidable deaths, caused by these decisions.
People with learning disabilities have been given do not resuscitate orders during the second wave of the pandemic, in spite of widespread condemnation of the practice last year and an urgent investigation by the care watchdog.