What is the Value of a Vulnerable Life in a Covid World?

Mel Kennedy

‘Some of my disabled friends are being pressured by organisations to sign DNR forms in the case they are admitted to hospital with Covid. It's 2020. Disability should not mean you have any less right to life. We should all have equal access to that.’

- Francesca Martinez (@chessmartinez) 16th April 2020, via Twitter

Trigger warnings: coronavirus, discussions of death, and eugenics

The basis for this article was found (probably not surprisingly) on Twitter. Tweets by doctors and nurses pleading with people to look at the figures and act with common sense were all answered with a similar response – ‘but how many of those were clinically vulnerable?’, ‘how many of those had pre-existing conditions before COVID?’. Why did these people feel the need to single out the clinically vulnerable? I can’t help but wonder when we began this revival of eugenics theory, when did my life become acceptable to count as mere ‘collateral damage’ if the worst should happen? Why should any loss of life be acceptable?

The notion of ‘do not resuscitate’ orders on disabled people without prior consent or discussion is terrifying – not to mention illegal and unethical, but in the first wave of the pandemic this was a sorry reality in 21st century Britain. In some cases, GPs handed out DNR forms to elderly and disabled patients in a ‘blanket rollout’ and did not consider the individual cases or invoke a discussion, as is the legal requirement, even after an NHS England letter on 3rd April which stated all treatment ‘…should not be made on the basis of the presence of learning disability and / or autism alone’ (Murdoch, 2020). According to the Independent a doctor is not required to ask a patient for consent surrounding a DNR order but must consult the patient or their family in circumstances where the patient is not able. It is a basic human right.

Supported and residential care provider, Turning Point, revealed concerns in April over 13 unlawful DNCR or DNRs from GPs and hospitals since the beginning of April, with half which appeared in a week. Turning Point was determined to challenge the unlawful DNRs (Thomas, 2020).

The Independent gave the example of a man in his fifties with sight loss. Having been incorrectly diagnosed with coronavirus he was sent home with a DNR form, with the reasons stated as ‘sight loss and severe learning disabilities’. Another case was that of a man with epilepsy but no other conditions, who had a DNR and instructions not to be taken to hospital overturned by his relative (Lovett, 2020).

A Parliamentary committee document in September revealed that out of 50 COVID-19 deaths of people with learning disabilities, 78% had a DNACR (do not attempt cardiopulmonary resuscitation) decision recorded and made prior to their deaths. The report also recorded concerns that many deaths of people with mobility impairments and/or mental health issues may have been because of prejudice towards disabled people with COVID-19 and judgements based on ‘ceilings of care’ or, essentially, the value of that life and the resources it would take to save them.

A Mencap statement read:

‘The 1.5 million people with a learning disability across the UK have a right to equal access to healthcare just like anyone else. Yet the potentially unlawful use of ‘Do Not Resuscitate’ (DNR) notices for fit and healthy people with a learning disability during the first wave of the COVID-19 pandemic was discriminatory and quite literally put their lives in danger.’

Worse still, moving further into Twitter I saw tweets which suggested that clinically vulnerable people should stay indoors and everyone else ‘should be allowed to get on with their lives’ as if disabled and ‘clinically vulnerable’ people are less than entitled to a life, as if the aim to stay home and save lives has long since worn its welcome.

We know you’re frustrated; we know you’re angry. This pandemic has cost lives, cost livelihoods, cost social freedoms and experiences – but take that anger and use it to make change, to challenge those handling this crisis. Don’t turn it on those who are vulnerable – we’re all in this together, and that isn’t going to change any time soon.

References

Equally Ours (2020). Equally Ours -Written Evidence (LBC0289). [online] Available at: https://committees.parliament.uk/writtenevidence/10900/pdf/. {Accessed on: 12 Jan. 2021]

Lovett, S. (2020). Investigation launched into blanket use of ‘Do not resuscitate’ orders during pandemic. [online] The Independent. Available at: https://www.independent.co.uk/news/health/coronavirus-do-not-resuscitate-orders-nhs-hospitals-latest-b986595.html [Accessed 12 Jan. 2021].

Martinez, F. (2020) [Twitter] Available at: https://mobile.twitter.com/chessmartinez/status/1250757016001433600 [Accessed 12 Jan. 2021]

Murdoch, C. (2020). NHS England and NHS Improvement Letter DNACPR. [online] Available at: https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/04/C0166-Letter-DNACPR.pdf [Accessed 12 Jan. 2021].

Thomas, R. (2020). ‘Unprecedented’ number of DNR orders for learning disabilities patients. [online] Health Service Journal. Available at: https://www.hsj.co.uk/coronavirus/unprecedented-number-of-dnr-orders-for-learning-disabilities-patients/7027480.article [Accessed 12 Jan. 2021].