The Government Needs to Come Clean About the Role of Midazolam in the Pandemic

I want to start by making two points.

Firstly, this post is about deaths. This isn’t an abstract concept – there were real people who were alive one day and dead the next. I knew some people who died during the Covid waves in 2020 and 2021, including one very good friend, and I miss them all. I ask that readers try to bear this in mind when thinking about the concepts that I’ll explore in this post.

Secondly, I must apologise to those who lost loved ones during the Covid waves in 2020 and 2021, because this post won’t help them in their grief. Nothing that is said now will bring them back, but it could bring back harsh memories that were best kept in the past, and introduce new uncertainties that will only make the grief worse. I’d very much have preferred to not have had to make this post, but it is important that we know what has happened so that we can learn from any mistakes that were made and try to ensure that they can’t be made again in the future.

Recently there have been a few posts on the topic of the use of midazolam and morphine to hasten death during the Covid waves in spring 2020 and winter 2020-2021. Most notable are the videos made by Dr. John Campbell and the posts of Professor Norman Fenton.

These reference a document issued by the National Institute for Health and Care Excellence, NICE, on April 3rd 2020 regarding treatment for those suffering from Covid, and which included a section on treatment for those near the end of life. This end-of-life care centred around the use of morphine and midazolam to ease the suffering of these individuals (as well as potentially other drugs: haloperidol and lorazepam).

The question that is now being asked is whether this end-of-life treatment might have been used too hastily, resulting in the death of individuals who might otherwise have survived. It is important to note that these guidelines came from NICE – this isn’t a simple guidance for medics, but a set of rules that they have to follow unless they have good reason to do otherwise.