Alert: Pandemic Protocol at Yale New Haven Health Restricts Life-Saving Efforts for Some Patients

The PAR newsletter has received a copy of the “Yale New Haven Health Resuscitation Protocol for the COVID-19 Pandemic,” updated and issued to all medical staff on November 12. It was accompanied by the following comments.

Couched in vague language open to wide interpretation, this memorandum’s overall point is clear: even if critical care patients and/or their representatives desire intervention such as resuscitation or intubation, or have not yet made their wishes known, they may nevertheless be assigned “Do Not Resuscitate/Do Not Intubate” status by agreement of “two or more physicians.” While patient wishes, or those of their advocates, are to be “considered” if they can be “obtained,” the system is not bound to honor them, and is unlikely to do so if they contradict practitioners’ assessments.

It is stated that one reason to limit (or prohibit) cardiopulmonary resuscitation of “critically ill patients with COVID-19” is to avoid “exposing health care workers to high risk of infectious transmission,” a laudable goal on the face of it. Health care workers have been truly heroic in doing their jobs during this pandemic under terrible conditions. But they know that theirs is not a no- or even low-risk job. And PPE including face shields and masks are more available now than they were in the earliest days. Meanwhile, people go to the emergency room and to the hospital seeking critical care, believing in good faith that they will receive it. Are they to be denied that care because providing it has become too risky? And are people now required to merely accept the judgment of doctors they may never even have met, knowing the health care system is under serious economic pressure to have fewer, less critically ill patients?

The memo states that, in addition to this “system-wide notice,” “ the YNHHS Chief Clinical Officer, in collaboration with the YNHHS Chief Executive Officer and YNHHS Senior Vice President and General Counsel…shall determine an appropriate manner of notifying the public, patients and other stakeholders.” (Emphasis added.)

Since this is an update of a memo originally circulated in April which, to our knowledge, was never made available for public comment or scrutiny, PAR decided its readers should learn about this in a timely manner. Feel free to email us for a copy of the full memo at [email protected].