Doctor: People should discuss end-of-life plan before coronavirus emergency

A senior medic has urged frail patients in Northern Ireland to discuss end-of-life arrangements with their families while they are still well.

Dr Hamish Courtney, from the Royal College of Physicians of Edinburgh – an organisation working to improve patient care, said it is important that those dying from coronavirus do so peacefully.

Stormont’s Health Committee was taking evidence on decisions whether to ventilate and the use of “do not resuscitate” notices for the weakest.

It is about providing compassion, care, allowing people to die peaceful and dignified deaths if that is possible

Dr Courtney said: “This is not just about Covid-19, although it has brought it into sharp focus.

“It is not just about rationing.

“It is about us as a society, doctors with their patients and families and individuals, discussing end of life.

“It is about providing compassion, care, allowing people to die peaceful and dignified deaths if that is possible.”

He said people should speak to GPs and healthcare professionals before that emergency stage develops.

The doctor added that it is not a decision to be forced on people.

Alliance Party Assembly member Paula Bradshaw said she had received an email from a constituent, which said a woman’s husband had been told he would not be taken to the intensive care unit if he “had a turn for the worse”.

The Belfast South MLA branded it “callous, cold and devoid of humanity”.

Official guidance says some patients could have acute treatment withdrawn to instead offer it to those with a greater chance of survival.

The British Medical Association (BMA) has set out guidelines on the rationing of care if the NHS is overwhelmed by new cases.

BMA ethics guidance says: “If services are overwhelmed during this pandemic, health providers will put in place – or expand – systems of triage.

“Triage is a form of rationing or allocation of scarce resources under critical or emergency circumstances where decisions about who should receive treatment must be made immediately because more individuals have life-threatening conditions than can be treated at once.”

Many relatives have spoken of the heartache over recent weeks of not being able to visit loved ones as they die from Covid-19.

The Royal College of Physicians of Edinburgh influences health policy to improve the quality of care and patient safety.

Its president Professor Andrew Elder said: “Decisions regarding the presence of family at the bed side of their dying are not simply matters of infection control. And we should not permit them to be such.

“They are matters of our humanity.

“Matters that define who we are, our understanding of what life is, and how our lives must all end.

“We must consider these feelings as much as we consider the risks.”