Doctors less inclined to resuscitate since pandemic

THE pandemic has increased doctors’ willingness not to resuscitate some patients, a survey suggests.

Blanket orders to not resuscitate some care home patients at the start of the pandemic were identified by a health watchdog last year.

Previous research had led to concerns that “do not attempt cardiopulmonary resuscitation” (DNACPR) decisions applied to almost a third of patients admitted to hospital with suspected Covid-19 in the virus’s first wave.

However, the survey of 231 doctors, including consultants, GPS and junior doctors, published in the BMJ Journal of Medical Ethics, found that more than half (54 per cent) were making more patients DNACPR now compared to the period before the pandemic.

Just 2 per cent of respondents said they were applying the decision to fewer patients now than pre-pandemic.

Participants were also asked which factors significantly contributed to their DNACPR decision making, both before and during the pandemic.

The most cited reasons included the “likely futility of CPR” – 88.3 per cent before versus 90.9 per cent during the pandemic – and patient co-morbidities – 88.7 per cent both before and during the pandemic. However, patient age and resource limitations were an increasingly important factor informing their decisions. Patient age as a reason increased from 50.6 per cent to 59.7 per cent during the pandemic, while citing of resource limitations rose from 2.6 per cent before, to 22.5 per cent.

Caroline Abrahams, charity director at Age UK, said while it was not possible

‘Older people have the same rights to help from the NHS as any one else and doctors’ judgments must be objective’

to draw hard conclusions from the small survey, “it reminds us to be on the lookout for any signs of the pandemic having permanently raised the barriers” in the way of older people getting the appropriate treatment for them.

“We know that during the early stages of the pandemic, when hospitals generally and ICUS especially were under huge pressure, some older people were unable to access the treatment they wanted and required,” she said.

“That must not be allowed to become ‘the new normal’: older people have the same rights to help from the NHS as any one else and doctors’ judgments must be objective and based on clinical need.”