(This article was rejected by The Telegraph)
By Jacqui Deevoy
Since March 2020, the UK’s elderly have been asked by their GPs to sign Do Not Resuscitate agreements, but in care homes and hospitals DNRs are automatically being put in place, often without the consent of the patient, resident or their loved ones.
After my father had a major stroke last October, it was decided that he should be placed in a care home. Unlike the other residents, he’s not old: at 76, he is among the youngest. Prior to his admission to the care home in January 2020, when he was still in hospital, I was told by doctors there that he’d been diagnosed with vascular dementia. I accepted this diagnosis as he did seem to be displaying many symptoms of this terrible disease – namely confusion, forgetfulness and mood swings.
In May, I had a call from a nurse at the home, who wanted some help updating his records. During this conversation, it became apparent that my dad had a DNR (Do Not Resuscitate) order in his medical notes. I asked who had signed it and when. After much paper-flicking, it turned out the form had been signed by a doctor from the hospital he was admitted to back in October and the next of kin signature was from someone who was not next of kin (but who’s a non-blood-related member of the family) and who also happens to be a nurse at the hospital. It had been signed FOUR DAYS after he’d had his stroke – on October 25th – when he was unable to speak or move, so he’d clearly not been consulted. As my dad’s next of kin, I had not been consulted either.
I expressed my upset over this and asked the nurse to clarify what a DNR actually meant for my dad. She told me that if he stopped breathing or if his heart stopped, there would be no medical intervention. While she moved swiftly onto the next page of her questionnaire, I was left speechless. I had to interrupt her.
“So you’re saying that if my dad stopped breathing for any reason, he’d get no help and would be left to die?” She told me that was correct.
“If he had CPR,” she explained, “it wouldn’t go well: ribs would be broken, he’d be left in a vegetative state and would be a terrible burden on his family.” She said this off-pat and as if all those awful events would definitely happen. It sounded like the regular ‘sell’ they might be giving all residents and their families. She then tried to change the subject.
“Hang on,” I interrupted. “What if I don’t want him to have a DNR?” She told me to speak to the care home manager.
I emailed the manager. The next day, the manager left me a voicemail. “The DNR form was signed by a consultant at the hospital. We cannot just remove the form from his file. And, as your dad has capacity, I spoke to him today and he has agreed that he does not wish to be resuscitated. It was a witnessed conversation.”
How can a man in a dementia unit of a care home be expected to make a (literally) life or death decision without the input – or, indeed, the protection – of next of kin?
I didn’t want to involve my dad but, as I hadn’t yet received confirmation of Power Of Attorney over his health and welfare (applied for in February), I felt I had no choice.
“Yes,” he replied when I asked him whether he’d agreed to a DNR. “If I die, I die,” he stated flatly. “I don’t want to be resuscitated and be a burden.”
I tried to explain to him that he may have been cajoled into making that decision, but he became irritated. He won’t hear a bad word against doctors and nurses as, according to him, they’re all lovely and have his best interests at heart. I ended the chat because I felt bad enough mentioning it in the first place. Before his stroke, I know he wouldn’t have wanted this: he liked being alive but the brain injury he’s suffered has made him a different, more docile and definitely more depressed man.
So many relatives of people in care homes are dealing with similar problems. Some are oblivious to whether their loved ones have a DNR in place; some are aware there’s one because their relative wants one; some have decided a DNR is for the best; others, like me, are struggling to work out why such a decision has been made for relatives with Alzheimer’s, dementia or general confusion after a stroke, with no conference to the next of kin.
I decided to speak about DNRs to a consultant at a London NHS hospital. What he revealed was shocking. “I am horrified by what is happening at NHS hospitals across the UK right now,” he said. “All patients over 60 automatically get a DNR, without them or any family members being consulted. I’ve seen the forms in their files with my own eyes. It’s not just the over 60s that get them – I’ve seen them being put in place for young people with mental health issues, for physically disabled people of all ages and for autistic people. We had a schizophrenic woman in her early 30s admitted recently and I found a signed DNR form in her file. She hadn’t been asked whether she wanted one or not.”
But surely it’s illegal to do this? The consultant says not. “Since the Coronavirus Bill was passed in March, we have all had pretty much all of our human rights taken away. That includes medical rights. There’s no longer any body autonomy. Your body and your life is not your own. Once a person is admitted to hospital, they are the property of the hospital. A doctor can now override the wants and wishes of a patient and their family. I’ve seen notes stating that the patient and family does not want a DNR and the notes are scored out with the words ‘overridden by doctor’ across them.”
The consultant, who has worked as a cardiologist for over three decades, says he is so upset by what’s happening that he’s decided to take early retirement. “I’m not here to allow patients to die unnecessarily. Every person should have a chance of life: a second chance even. I’ve seen many people resuscitated after heart attacks who’ve gone on to live another 10, 20 or 30 years. The only reason for these DNRs – and I hate to admit this – is to get rid of what Henry Kissinger once referred to as “useless feeders”, people who are seen to be a drain on the world’s resources. In simple terms, it’s a cull of society’s most vulnerable people. In a single word, it’s eugenics. People used to laugh and think the whole idea of depopulation was the stuff of conspiracy theories, but it’s happening right now, behind the closed doors of our near-empty hospitals.”
The doctor went on to describe patients being given the wrong treatment during the Covid 19 pandemic, only to result in their untimely deaths. “I’m not saying for a minute that the doctors or nurses are at fault. They’re doing their absolute best and think they’re doing the right thing by following protocol. This applies to DNRs too. The problem lies with the bureaucrats, the ones developing the protocol. Those people have blood on their hands.”
Comment from the care home press office: “We cannot comment on individual cases out of respect for the privacy of our residents. What we can say is that the wellbeing and wishes of all our residents are considered in everything we do and this extends to some of the most difficult end of life decisions. Our process is always to respect the wishes of our residents and where they have capacity, decisions such as the signing of a Do Not Resuscitate order (DNR) remain very much up to a resident and their clinician/doctor. In cases where a resident lacks capacity the appropriate medical professional should consult with the next of kin or power of attorney on medical decisions. This can include the signing of a DNR. It is also important to note that we review our residents’ medical requirements on an ongoing basis as decisions pertaining to what is best for an individual can change depending on a multitude of factors such as care setting or changes to a resident’s condition.”