I WRITE in support of Dr Knox’s video (Westmorland Gazette, April 9) which is in no way suggesting that people with coronavirus should “give up” or not be treated if they fall into a vulnerable group.

As someone who has worked professionally and voluntarily in the hospice sector, this is the sort of conversation we have been encouraging anyone to have with family and health care advisers for years and still do.

Patients with many diseases – cancers, motor neurone disease etc. often come up against the issue of treatment being futile or perhaps more burdensome than accepting palliative care when comfort and relationships beat the horrors of some last ditch treatment attempts.

COVID-19 is just another example of this, even if more headline-grabbing than the others, where intensive care in the absence of loved-ones may not suit us all or be in our best interests.

Also, conversations like this with family and advisers, especially if backed up by an enduring power of attorney, can ensure that less predictable situations – sudden major illness or accident, for example, can also be covered and treatments be tailored to both clinical and personal needs.

It is really a natural extension of the advice that everyone should write a will.

We none of us wish to think about death and dying much of the time, but they are inevitable so some preparation can be very reassuring for ourselves, family members and also of great assistance to health care practitioners whom we might encounter without warning and without the capacity to contribute to decisions about treatment.

There have been episodes in Italy recently where health workers have had to make judgements based on their own interpretations, when intensive treatment for all needing it was not possible due to resource limitations – fortunately something so far we have not encountered here despite the huge demands for intensive care – surely, preliminary consideration by patients and potential patients would help in such drastic situations.

Also there are press reports of people being pressured to make Do Not Resuscitate decisions, especially in care homes.

This is likewise a very rational thing to discuss, ideally in advance, but is distinctly unethical if it is done (or seen to be done) as part of a move to restrict or ration services.

My guess is that the professional judgements and personal wishes would generally match when people are able to have meaningful conversations in advance but, where they do not, there is no suggestion that patients should be denied all available treatments.

Stay safe but consider your wishes and aspirations if illness strikes, discuss it with family and advisers, and record it – perhaps through a power of attorney.

Then if the worst strikes, whatever happens may be less distressing all round than if no-one has any idea of what might or might not be your wishes or in your best interests.

Dr Mike Warren,


Dugg Hill