British Doctors Order “Do No Resuscitate” Those with Mental Disabilities


John Stonestreet

Roberto Rivera

On a cultural level, COVID-19 did not create as many problems and challenges as it revealed and escalated. Like the medical co-morbidities that made the virus more dangerous and more deadly for individuals, cultural pre-existing conditions only worsened during the pandemic. Social distancing and lockdowns, for example, made our pre-existing cultural problem of loneliness that much worse for many.

In the same way, the general, widespread disregard for the those with intellectual disabilities in our culture made their mistreatment during the pandemic easier as well. For example, during the first wave of the pandemic in Great Britain, various facilities that care for people with intellectual disabilities, what the Brits call “learning disabilities,” issued blanket “Do Not Resuscitate” orders. These orders came, according to one source, directly from doctors, without consulting the patients or their families.

In December, following public outcry, Britain’s Care Quality Commission investigated and found that the orders were, in their words, “inappropriate” and should be rescinded. That was not, however, the end of the problem.

According to the Guardian newspaper, people with intellectual disabilities such as Down syndrome continue to be told that they will not be resuscitated if they become ill with COVID. This despite last year’s public outcry and the Commission’s report and instructions. Also, given that “people with [intellectual] disabilities aged 18 to 34 are 30 times more likely to die of COVID than others the same age,” a Do Not Resuscitate Order is a practically a death sentence.

This horrific practice has nothing to do with medicine. DNR’s are usually reserved for people too frail to benefit from CPR, which is not the case here. As one advocacy group told the Guardian, “some [orders] seem to have been issued for people simply because they had [an intellectual] disability.”

Why single out people with intellectual disabilities? The immediate answer is obvious. The doctors issuing these orders are eugenicists, willing to eliminate patients who, they think, drain resources. The larger answer is also obvious. Embedded in Western culture is a tendency to commodify human life, valuing people based on extrinsic abilities and appearances. Thus, the disabled are not deemed as valuable as the non-disabled.

In the U.K., this thinking is obvious in other ways, too. For example, a positive Down syndrome in utero test results in an abortion 90 percent of the time. Attempting to “explain away” this terrible number by noting that not all pregnant women are tested for trisomy 21 does not change the awful, inconvenient fact: When a British woman is told her unborn child has Down syndrome, she is nine times more likely to kill the child than to keep it.

To be clear, in this respect, Britain is a typical Western nation. In countries like Iceland and Denmark, the percentage of abortions following positive test is nearly 100 percent. In addition, the Danish and Icelandic governments have made prenatal testing for Downs syndrome almost universal.

In a now infamous 2017 tweet, CBS News announced that Iceland is “on pace to virtually eliminate Down syndrome ….” The language chosen by CBS News only revealed they shared Iceland’s eugenic impulse. As actress Patricia Heaton replied, Iceland “was not, in fact, eliminating Down syndrome. They were just killing everyone who has it.”

It’s hard to think of a clearer example of some lives being considered worth less than others, based on the criterion that what constitutes a “worthwhile life” is what the person can do. As medical ethicist Chris Kaposy has written, “Western cultures value independence, and consequently people with high levels of dependency are often stigmatized.” A more-accurate word, at least under some circumstances, would be “loathed.”

Even “feel-good” stories about individuals with disability finishing a triathlon, or being a model, or scoring in a basketball game can betray sub-narratives of dehumanization. We end up “celebrating” these people for what they’ve done, not who they are, or how they mimic those things that earn value in our culture, rather than their intrinsic worth and dignity as Image-bearers. The stigma against these individuals remains.

The British “Do Not Resuscitate” orders took place in the midst of the pandemic, but the ideas that led to them existed long before. COVID-19 gave cover for these ideas to be put in practice under the guise of some “greater good” or “necessity.”

Recently, a British joint committee on vaccinations announced that those with intellectual disabilities would be prioritized for the COVID-19 vaccine. That’s good news, although it is likely merely a reaction to the scandal, but it doesn’t address the eugenic impulse prevalent in so much of Western culture and medicine. Which means long after the COVID-19 emergency has passed, we’ll still need to confront and displace the very bad idea that some lives are worth less than others, and we’ll still need to stand up for and protect the victims of that very bad idea.


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