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Editorial: The Do Not Resuscitate scandal: do ‘all lives matter’?

THE scandal over the imposition of Do Not Resuscitate (DNR) orders in care homes exposes the ugliest side of the British state’s response to Covid-19.

The government has long denied that the Prime Minister’s top adviser Dominic Cummings ever defended the so-called “herd immunity” strategy with the words “protect the economy, and if that means some pensioners die, too bad.”

Even so the government’s indifference to protecting certain sections of the population is clear. The discharge of thousands of people into care homes from hospitals between March and April, without testing them for Covid-19, took place despite warnings that the sector was not in a position to protect residents or staff from it, with chronic shortages of personal protective equipment (PPE). 

Some ministers, like Lord Chancellor Robert Buckland, argued that this was because they had to prioritise protecting the NHS, and certainly limited stocks of PPE were requisitioned from care homes for the NHS. 

Yet the health service’s own dire shortages of tests and equipment were the government’s fault — both for failing to take action when warned about the risks of Covid-19 at the start of the year, and for allowing stocks of PPE to run short and expire beforehand despite predicting the consequences in drills like 2016’s Exercise Cygnus.

The DNR scandal touches on two questions: how valuable are the lives of vulnerable people to those in authority? And is it possible or not to deploy a society’s resources to protect everybody’s rights?

That one in 10 care homes received instructions from NHS managers to change resuscitation orders for residents without consultation clearly indicates a hierarchy on how lives are valued. 

The orders were ostensibly to stop hospitals running out of beds. But we know they did not simply reflect a harsh but rational approach to who was most likely to survive because half the cases concern homes for people with learning or cognitive disabilities — much as an autistic care provider reported in April that it had been told by a GP surgery to apply DNRs to autistic adults.

These people were no less likely to recover from Covid-19 (or other illnesses) than the population at large. A value judgement had been made that their lives were worth less.

This is hardly surprising in a country where disability hate crime has been rising for years, as Tory propaganda about “scroungers” and “benefit cheats” whips up suspicion and hostility of disabled people.

But the level of institutional discrimination it exposes should prompt the entire movement to respond in solidarity. The lives of disabled people are as important, and with appropriate support can be as fulfilling, as those of anyone else.

When it comes to homes for the elderly, ministers’ calculation throughout appears to be that the old are dumped in care homes to die anyway and if the mortality rate increases for a while it won’t raise too many eyebrows.

The ruling ideas of every society are the ideas of its ruling class and whatever the sentiments of millions of us towards our relatives, our society is not one that values those too old to live independently. 

Poverty pay in the social care sector reflects this, as the epidemic of loneliness among the elderly illustrates it. An atomised, insecure workforce, compelled to move to where “the market” wants them because the availability of productive work across the nations and regions of Britain is not the government’s concern, has frayed the community and family networks that we all live and die among.

The dilemmas this throws up are often framed fatalistically, the result of the march of globalisation. But if the result is to accept that the lives of the old are no longer important, it is the economic system responsible that should be put out to grass.

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