Experts: Universal do-not-resuscitate orders are unethical, un-American, unnecessary
WASHINGTON, D.C., March 30, 2020 (LifeSiteNews) – Amid the many narratives and news reports competing for attention during our Coronavirus Pandemic Spring, one of the most alarming for pro-lifers was a recent Washington Post headline that screamed, “Hospitals consider universal do-not-resuscitate orders for coronavirus patients.”
To Catholics and many others, the notion that hospitals might mandate that their doctors and nurses ignore coronavirus victims as they face a medical emergency and allow them to die alone in their hospital rooms is anathema.
The article suggests a high probability that hospitals will be forced to ration medical treatment, equipment, and supplies, while painting a gruesome dystopian picture of medical professionals’ well-being pitted against that of their patients.
It’s a portrait of a world where hospitals and healthcare systems are guided by Darwinian logic, where only the young and fittest are chosen to survive while those over 60 or who have pre-existing medical conditions are left to die, perhaps provided only with end-of-life “comfort care.”
It suggests that the icy cold inhumanity of the culture of death – aka, the “throw away society” where human life deemed “inconvenient” or a burden is discarded – which began with Roe v. Wade is about to reach its logical conclusion.
Stories out of Italy about its valiant struggle to cope with what became a deadly, out-of-control virus that quickly overwhelmed that country’s healthcare system have served to fan the flames of fear in the U.S.
But the United States is not Italy.
Caution against extreme predictions
Following publication of the Post article, Dr. Deborah Birx, White House response coordinator for the coronavirus task force, pushed back against the article’s dire tone and claims.
“There is no situation in the United States right now that warrants that kind of discussion,” said Birx.
“It's our job collectively to assure the American people,” added Birx. “It's our job to make sure that doesn't happen.”
“I want to emphasize caution about extreme predictions,” John A. Di Camillo, PhD, BeL, Staff Ethicist at The National Catholic Bioethics Center (NCBC), told LifeSiteNews. Di Camillo noted that queries from hospitals and medical professionals to the NCBC have been on the rise in recent weeks.
Hospitals cannot establish a rule that sentences people to death
“We’re reading the unthinkable—the Seattle Times reported that Washington State and hospital officials have been meeting to consider how to decide who lives and dies,” noted Peter Breen, Thomas More Society Vice President and Senior Counsel in a statement for the Freedom of Conscience Defense Fund.
“In our nation’s capital, the Washington Post is running editorials about the ‘nightmare’ of rationing health care, as is the National Review in the hard-hit state of New York,” continued Breen. “The horrific idea of withholding care from someone because they are elderly or disabled, is untenable and represents a giant step in the devaluation of each and every human life in America.”
“I am uncomfortable with a standing do-not-resuscitate order,” legal expert Charles LiMandri told LifeSiteNews. “It seems to me [hospitals] are going to have to do it on an ad hoc basis and do the best they can with whatever equipment and personnel are available in each situation.”
“It just doesn’t seem to me you can have a rule that sentences people to death,” added LiMandri, partner at LiMandri & Jonna LLP, who serves as Special Counsel for the Freedom of Conscience Defense Fund and the Thomas More Society.
“A pandemic or existential threat does not negate our moral obligations,” wrote R.J. Snell in a statement for the Charlotte Lozier Institute, addressing the principles that have long guided healthcare professionals. “We may never knowingly and intentionally do wrong, even for good results, even in a crisis situation. In addition to general moral norms, professional codes of ethics continue to apply.”
“The duty to care persists,” said Snell, Director of Academic Programs at the Witherspoon Institute in Princeton, NJ, and Academic Director of the Aquinas Institute for Catholic Life at Princeton University. “Members of the health care profession assume an obligation to provide care and to be available during an emergency, even at some risk to their own health and life.”
“Physicians take an oath to always act in the best interest of [their] patients. It’s an oath that has guided physicians for over 2,400 years,” said Dr. Dennis Sullivan, the Christian Medical and Dental Association’s Ohio Representative, and American Academy of Medical Ethics Professor Emeritus of Pharmacy Practice, Cedarville University in an interview with LifeSiteNews.
“We need to trust the medical profession right now, not live in fear of it,” he declared.
‘Rationing care is a surrender to death’
“People have become too accustomed to taking the easy way out of dilemmas, and too comfortable with making excuses for killing when the only offense of those we kill is the possibility of inconvenience,” wrote Allen C. Guelzo, senior research scholar in Princeton University’s Council of the Humanities and visiting fellow at the Heritage Foundation in a Wall Street Journal op-ed titled “Rationing care is a surrender to death.”
“Americans are better than that,” continued Guelzo. “Ventilators are not simple to manufacture, but neither were Spitfire fighter planes at the beginning of the Battle of Britain. Improvise, innovate, imagine.”
When it comes to the practice of medicine, America is resource-rich
“These are gut wrenching questions,” said Di Camillo, “but we should all be thinking – patients and providers – about the kinds of sacrifices that we may need to be willing to make to help each other.”
“There are wonderful solutions that can help us when we come together as a community,” he noted.
In Italy, where the healthcare system has been overwhelmed, there have been stories of creative solutions emerging. “People are converting scuba diving gear into personal protective equipment for doctors and nurses.”
Di Camillo also noted how Italian clothing design and manufacturing titan Giorgio Armani has also agreed to produce personal protective equipment. “Private initiatives paired with community level and government initiatives to creatively respond” open up previously unavailable possibilities.
“We are a resource-rich country here in the United States. We’ve never been faced with a lack of resources,” said Dr. Sullivan regarding the possibility of unilateral or mandatory do-not-resuscitate (DNR) orders.
“After the 2009 H1N1 influenza pandemic, there was a big push by a number of institutions to have allocation protocols that would triage patients,” Sullivan told LifeSiteNews, “especially with regard to ventilators.”
“Here’s the key thing that needs to be pointed out: Many hospitals and healthcare systems have had these protocols in place for years, but they have never, ever, ever been used,” emphasized Sullivan.
Will hospitals start limiting access to ventilators?
“There are some very creative ideas out there,” that would avoid the need, noted Sullivan. “For example, they’re talking about the possibility of putting a ‘Y’ connector or a ‘T’ connector on ventilator hoses so that two patients can be ventilated at the same time” using a single machine. Such a move would quickly and inexpensively double the county’s ventilator capacity.
Perhaps in a way not witnessed since World War II, American businesses, small and large, are mobilizing to supply the needs of medical professionals fighting on the front lines against the coronavirus.
Local distilleries which normally produce whiskey have quickly converted to hand sanitizer production.
“My Pillow” founder and CEO Mike Lindell announced that his company has shifted 75 percent of its manufacturing capacity to produce face masks for hospitals across the country. And General Motors has already teamed up with Ventec Life Systems and is gearing up to manufacture up to 10,000 ventilators per month at its factory in Kokomo, Indiana.
A crucial abundant resource cut off: Pastoral, sacramental care
“There is a real danger here that I’m seeing of spiritual and pastoral care being pushed out to the side,” observed Di Camillo, due to the risk of contagion.
“We have to find ways to get priests to minister to patients who are suffering,” said Di Camillo, who noted that it’s not just patients, but hospital staff also are in need of spiritual support.
“We need an intensification of spiritual support, pastoral support, sacramental support,” he stressed.