COVID-19 Outbreak Update: Hospitals Mull Do-Not-Resuscitate Orders

Doctors and officials at several hospitals in the U.S. are now in talks over a proposal to stop resuscitating a patient with COVID-19. The decision comes amid a national shortage of protective equipment and the growing number of people with the contagious virus. 

Some health experts expressed concern that the “do-not-resuscitate” policy would reduce some patients’ chances for survival. However, they also agreed that the lack of protective gear at hospitals will expose more people, mainly doctors and nurses, to COVID-19 when saving a single person. 

At Northwestern Memorial Hospital in Chicago, officials are looking at the new policy for infected patients. It would allow doctors to decide not to resuscitate a COVID-19 patient regardless of the wishes of the patient or its family, the Washington Post reported Thursday.

“It’s a major concern for everyone,” Richard Wunderink, an intensive-care medical director at Northwestern, said. “This is something about which we have had lots of communication with families, and I think they are very aware of the grave circumstances.”

Similar conversations also occurred at George Washington University Hospital. For now, officials said the hospital will continue to resuscitate coronavirus infected patients but with modified procedures, like using plastic sheeting over the patient to avoid droplets from spreading at the facility. 

Officials at other hospital systems, including Atrium Health in the Carolinas, Geisinger in Pennsylvania and regional Kaiser Permanente networks, plan to make a similar policy that would allow doctors to override the wishes of the coronavirus patient or family members. But it would be on a case-by-case basis, looking at the risk to doctors and nurses and availability of protective equipment.

“From a safety perspective you can make the argument that the safest thing is to do nothing,” Bruno Petinaux, chief medical officer at George Washington University Hospital, said. “I don’t believe that is necessarily the right approach. So we have decided not to go in that direction. What we are doing is what can be done safely.”

But he noted that hospitals must “assess and evaluate” their resources before implementing a do-not-resuscitate policy. Some health facilities remain with sufficient equipment and manpower but the number of patients with COVID-19 is expected to continue rising.

Coronavirus COVID-19 Doctors New York, USA Doctors test hospital staff with flu-like symptoms for coronavirus (COVID-19) in set-up tents to triage possible COVID-19 patients outside before they enter the main Emergency department area at St. Barnabas hospital in the Bronx on March 24, 2020 in New York City. New York City has about a third of the nation’s confirmed coronavirus cases, making it the center of the outbreak in the United States. Misha Friedman/Getty Images