‘Independence Day’ – the U.K.’s own Horror Story

The so-called “Independence Day” U.K. is taking place on the 4 July while the virus is still claiming lives and no vaccine or effective treatment yet exists. To add sweetener the government has reinstated the national “clap” for the NHS on the day following.  Once again the valse triste of happy clappers is enacted at the behest of hypocrites like Matt Hancock, who on the 18th May rejected a proposed pay rise for the nurses. Also in May, 331 Tory MPs voted down a motion to provide NHS workers with routine weekly testing. 

Doug Paulley, campaigner for the disabled has said: “The late imposition of lockdown, the ‘herd immunity’ policy, and so on, all came across to me as ‘chuck the disabled and otherwise devalued people under the bus.’ An uncaring disregard for disabled people during a pandemic isn’t a passive act: it is active eugenics, and I call it out as such.”

A document known as the “COVID-19 Decision Support Tool”, revealed by the Financial Times in April, has been used by the NHS throughout the present crisis.

This NHS “scoring card” categorically sets out that only those patients having a combined score of under 8 points are considered for admission to an ICU intensive care unit). Those scoring above 8 would be considered solely for ward-based care or face mask oxygen.

Any patient over 70 years old or patient with an existing mental or physical disability becomes at best a borderline candidate for intensive care treatment.  For example, a patient aged 71 to 75 would automatically score 4 points for their age and in most cases a further 3 on the “frailty index”.

Any underlying conditions such as dementia, heart or lung disease, or high blood pressure can add 2 points to the score, thus excluding the patient from access to life-saving care- an effective sentence of death.

We have now in this country a social euthanasia programme, in direct violation of the norms and values of medical ethics and international declarations to which the U.K. is a signatory.  Medical practice now permits patients to be “de-prioritised” for life-saving solely on the basis of their age or existing mental or physical disabilities.

Against the background of the lamentable state of the NHS after years of neglect and cuts by both Tory and Labour governments, the British Medical Association (BMA) doctors’ union published advice to its members early on in the pandemic on how to “maximise overall benefit” of treatment if “demand outstrips the ability to deliver to existing standards.”

The advice was that should hospitals become inundated with COVID 19 cases, doctors “may be obliged to withdraw treatment from some patients to enable treatment of other patients with a higher survival probability.” 

How this actually translated into action was that as the panic spread, a preemptive measure delivered through the care homes’ local GPs was adopted.  “Do not attempt resuscitation” (DNAR) notices were added en masse to the medical records of elderly and disabled people in care homes, many without consultation with either the individuals themselves or their families.  

The Brighton newspaper The Argus reported as early as the 3 April that care homes were being told they should have “DNR orders on every patient”.  The instruction to GPs from Brighton and Hove Clinical Commissioning Group, “a leaked document reportedly reveals”, even came with a suggested script to use if persuasive conversations with residents were attempted.

Since all this has emerged,  concerns have now been raised over these blanket decisions placing DNR/DNAR orders on vulnerable care home residents and disabled people.

The issue was raised by POhWER, an organisation which provides Independent Mental Capacity Advocacy (IMCA) services to some of the most vulnerable people in the care system.

According to this group, residents in East Sussex – some with learning disabilities or autism – had been issued DNAR orders by GPs without “their knowledge” or “appropriate discussions” with family, carers or independent advocates.

POhWER says such decisions are likely to be a “national issue”, which represent a breach of “basic human rights” and “of common decency.”

The group’s deputy chief executive Elizabeth Hawkes said: “POhWER works in a large number of care homes across Sussex and we are aware there have been instances of blanket decisions regarding do not attempt resuscitation orders (DNARs) being placed on groups of people without their knowledge.”

This is clearly only the tip of the iceberg. 

This pandemic of SARS-CoV-2 cannot be used to subvert the national and international legislation that is in place to safeguard people’s rights, nor to suspend the requirements imposed by the Hippocratic Oath.  However, this nefarious ‘support tool’ and other guidance like it are designed to do just that.  They offer a de facto abdication of responsibility by the medical practitioner, one which leads to a denial of life-saving treatment, and an abrogation of the Hippocratic Oath.

The right to health is a fundamental plank of all human rights. The right to access “the highest attainable standard of physical and mental health”, is not negotiable. Internationally, it was first articulated in the 1946 Constitution of the World Health Organization (WHO).  The preamble to the document states that “the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction”.

The OHCHR (Office of the United Nations High Commissioner for Human Rights) crucially states:

“Health services, goods and facilities must be provided to all without any discrimination”. And further that “the right to EQUAL (my capitals) access to health care is a fundamental principle that is part of the human right to health care.”

But notwithstanding all of that, it’s Independence Day today, 4 July, for the herd community.

Patrick Carey

Image: A ‘visiting window’ at a nursing home in Wetherby, West Yorkshire designed to reduce transmission to vulnerable residents. Credit: Mtaylor848, published under CC BY-SA 4.0