Clarification and common sense
CLARIFYING “do not resuscitate” orders, common sense wanted over lockdown procedures and how Boris Johnson’s situation has made us all feel vulnerable were the issues discussed by columnists and guest writers in yesterday’s papers.
The Guardian
Palliative care doctor Rachel Clarke understood why people were distressed to read that doctors were “condemning elderly patients to a ‘do not attempt cardiopulmonary resuscitation’ order – a DNACPR – without so much as a discussion”.
“As tempers fray, sifting facts from hysteria may provide welcome reassurance,” she said. “Cardiopulmonary resuscitation – CPR – means something very specific. It is the term we use for chest compressions and electric shocks to a heart that has stopped beating. In a sense, the patient has already died: we are trying our hardest to resurrect them.”
She said that a DNACPR order did not mean that nothing would be done to save the patient’s life.
“All manner of other treatments may be appropriate, such as fluids, antibiotics, oxygen, admission to hospital or treatment in an intensive care unit. The only thing ruled out by a DNACPR is chest compressions and shocks to the heart.”
In fact, she said, the “aggressive” chest compressions – which usually break the patient’s ribs – are “rarely” successful.
“The heart cannot be restarted because the patient is too frail, too weak and waning,” she explained. “Their cardiac arrest has not been caused by a reversible problem. Rather, it is the natural end of their life – the heart has stopped because the patient is dying.
“Please know that if your doctor seeks to broach DNACPR with you, we are doing so not to ‘ration’ care but rather to ensure you are not unknowingly subjected to a futile and inappropriate treatment. We are not giving up on you. Pandemic or no pandemic, we are trying our very best for you.”
The Daily Express
Ann Widdecombe called for “a dose of common sense and proportionality” during the lockdown.
“The aim, dash it, is straightforward: to stop people getting too close to one another,” she said. “So why are the police harrying sunbathers when they are yards away from other people? Why shouldn’t people drive for more than 10 minutes given that in a car you can neither be infected by nor infect anyone? Why shouldn’t people walk on the beach? As long as people are not congregating, why does any of it matter?”
She did not understand why people could not kit themselves out in protective clothing and sit on the other side of the room from an elderly relative for a while.
Or how one person, who has self-isolated for three weeks, could not join another person, who has also self-isolated, in their own home.
“A reader writes to me with an intriguing question,” she said. “He points out that in the war every civilian – man, woman child – in this country was issued with a gas mask. So, asks, why not do the same the present emergency?
“It would certainly put us off touching our faces!
“So what is the Government’s answer?
“Meanwhile, Boris, for pity’s sake REST and get better. We need you.”
The Daily Mail
Sarah Vine said the news on Monday night of Boris Johnson’s admission to intensive care was a flashpoint for her.
“Or, as my teenage son put it: ‘This thing just got real’,” she said. “In the space of just a few short hours — a feature with this wretched virus — the situation changed dramatically.
“That the Prime Minister has been so badly affected by this disease is, in many ways, symbolic of the huge challenge we all face.”
She said the fact that the elected leader of the country now found himself in intensive care “cannot help but make all of us feel more vulnerable”.
“Boris has always been such a larger-than-life presence; such a bear of a man, personally and politically,” she added. “I’ve always found him to be one of life’s can-doers, a glass-half-full sort, the kind who cannot see a challenge without immediately wanting to wrestle it to the ground.
“If anyone had suggested even a month ago that a man like Boris might have belonged to the ‘vulnerable’ category of patients, they would have been laughed out of town.
“Boris? Surely the last person anyone would need to worry about.
“It is a sobering, sombre moment.”