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Rescinding Do Not Resuscitate Policy Was the Correct Decision

By Allison G. S. Knox
Contributor, EDM Digest

The coronavirus has raised a number of ethical issues associated with the personal lockdowns ordered by states and the federal government.

Recently, New York state health officials proposed a controversial policy guideline regarding patient care, which was then rescinded. According to the New York Post, “New York state just issued a drastic new guideline urging emergency services workers not to bother trying to revive anyone without a pulse when they get to a scene, amid an overload of coronavirus patients.”

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Not only were the proposed protocols controversial, they brought up numerous ethical issues where patient care was concerned.

Policies and Large-Scale Emergencies

As with many large-scale emergencies, ethical issues often arise during policy discussions. Some would say that disasters highlight the inequalities of a community in how it delivers resources. It is not news that the coronavirus has overwhelmed hospitals with a major influx of intensive care patients.

During this entire ordeal, New York state has become the epicenter of the virus with the most cases in the U.S. The coronavirus has taken hold there in a rather shocking fashion. The influx of patients is not only particularly concerning for how it affects New York area hospitals; it has also created ample opportunities to rethink patient management amid a pandemic emergency.

The policy not to resuscitate COVID-19 patients in cardiac arrest was clearly meant to protect first responders helping to triage those patients. The reasoning was that those individuals would make the logistics of caring for them tricky and potentially dangerous. Those who care for these patients are of course exposed to COVID-19, which creates ample opportunity for the virus to spread.

Thus, it should come as no surprise that the policy was intended to minimize potential COVID-19 cases. Essentially, it was a triage policy that created management problems because these critically ill patients were in need of intensive care.

The Rescinded Do Not Resuscitate Policy Stirred Up Questions Regarding Emergency Medicine Protocols

New York state public health officials made the correct decision in promptly rescinding the policy. While it would have helped to triage patients and minimize COVID-19 exposure, it stirred up arguments and questions regarding emergency medicine protocols. It also created the opportunity for confusion: Does this patient actually have COVID-19? Could this patient potentially recover from COVID-19?

When questions emerge surrounding emergency medicine protocols, it can be difficult for those responding to make the correct, educated decision to render appropriate emergency care. And when there are too many questions, patients could wind up improperly cared for. They ask for help, but potentially, they’re not receiving the care that they should.

Rescinding this controversial do not resuscitate policy was the correct move. Otherwise, interpreting the new policy had the potential to create patient care and ethical problems that would only complicate matters during the COVID-19 crisis.

Allison G. S. Knox teaches in the fire science and emergency management departments at American Military University and American Public University. Focusing on emergency management and emergency medical services policy, she often writes and advocates about these issues. Allison serves as an Intermittent Emergency Management Specialist with the Department of Health and Human Services, as At-Large Director of the National Association of Emergency Medical Technicians and as Chancellor of the Southeast Region on the Board of Trustees with Pi Gamma Mu International Honor Society in Social Sciences. She is also chair of Pi Gamma Mu’s Leadership Development Program. Prior to teaching, Allison worked for a member of Congress in Washington, D.C. and in a Level One trauma center emergency department. She is an emergency medical technician and holds multiple graduate degrees.

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