New York’s frightening new “do-not-resuscitate” guidelines for cardiac patients

If you’re one of the people who are crazy enough to venture out onto the streets of New York City this week (or simply can’t avoid it for professional reasons) and you’re unlucky enough to collapse on the sidewalk from a heart attack, I suppose all we can say is it’s been nice knowing you. Under new guidelines issued by the state Health Department, paramedics finding people in a state of cardiac arrest without a heartbeat are not supposed to go through the usual routines of attempting to restart the patient’s heart and respiration. In other words, assuming you are seen by an EMT who is following this guideline, once you’re dead you’re supposed to politely remain on your trip to the afterlife.

While paramedics were previously told to spend up to 20 minutes trying to revive people found in cardiac arrest, the change is “necessary during the COVID-19 response to protect the health and safety of EMS providers by limiting their exposure, conserve resources, and ensure optimal use of equipment to save the greatest number of lives,’’ according to a state Health Department memo issued last week.

First responders were outraged over the move.

“They’re not giving people a second chance to live anymore,’’ Oren Barzilay, head of the city union whose members include uniformed EMTs and paramedics, fumed of state officials.

Particularly in New York City, this isn’t the first such policy change to be issued. The Regional Emergency Services Council of New York (which is responsible for overseeing ambulance services in the Big Apple) issued an even more stern directive. Cardiac patients whose hearts could not be restarted on the scene are no longer supposed to be taken to a hospital “for further life-saving attempts.”

But under those guidelines, you at least still could get twenty minutes of effort to restart your ticker where they found you. If you combine these two directives together, you’re pretty much out of luck. If your heart stops, you’re a casualty of the war against the novel coronavirus. But you may not have to worry about it. The FDNY responded by issuing a statement saying that they would continue to offer the same levels of medical response service that they have in the past.

There’s a part of me that almost understands a move like this, at least in theory. On the one hand, the first responders are already overwhelmed. And as tough as their jobs already are, now they have to worry if the guy collapsed on the street is contagious with the virus. A desire by the state to keep them safe is at least laudable in that regard. Also, while New York was never as fully overwhelmed as some originally feared, the number of ICU beds available at some of the hospitals is still down near zero on some days, primarily because of COVID-19 patients.

But if you’ve ever listened to any of the near-death experiencers (NDE) out there, you know that’s it’s not a minor matter for them. Those few people who have shuffled off this mortal coil only to be dragged back to the world of the living generally come away from the experience with profound, life-altering views. And we’re still not entirely sure where that line between life and death is drawn anyway. If you can revive someone who has flatlined for several minutes, what was their condition during that time? Were they really, technically “dead?” If we’re to accept that, we must suggest that they were then resurrected, and that raises all sorts of philosophical and religious issues.

We should probably leave these decisions up to the individual paramedics who are out there on the front lines. If they can save a life, you just know that they’re going to want to try. Otherwise, why would they be in that profession to begin with?

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