Northern Ireland

Nursing home deaths due to PPE shortages are 'unethical'

`Would the families of the many vulnerable people in our society who died form the virus say the allocation of PPE and testing was reasonable, respectful, inclusive, or proportionate?'
`Would the families of the many vulnerable people in our society who died form the virus say the allocation of PPE and testing was reasonable, respectful, inclusive, or proportionate?' `Would the families of the many vulnerable people in our society who died form the virus say the allocation of PPE and testing was reasonable, respectful, inclusive, or proportionate?'

AN ETHICIST who spoke movingly of mother's death after a Covid-19 outbreak in her US nursing home warns loss of life due to lack of personal protective equipment (PPE) and testing in Northern Ireland facilities "infringe their human rights and equates to a complete and dangerous lack of respect".

Dr Melissa McCullough, a Royal College of Surgeons in Ireland visiting academic, said the north's `Covid-19 Guidance: Ethical Advice and Support Framework' for adult social care demands "respect, reasonableness, minimising harm, inclusiveness, accountability, flexibility, proportionality and community".

She asked "if the decisions-makers were following these principles, how were so many vulnerable people left unprotected?"

Following the death in April of her 73-year-old mother Donna Penrose, Dr McCullough sounded the alarm over "increasing accounts by staff and vulnerable residents in care and nursing homes in so many countries, including here in Northern Ireland, who have not been afforded the appropriate personal protective equipment".

In a new essay, she describes ethical frameworks as "a set of principles and values that provide a solid foundation for safe and ethical practice...to guide us in acting properly...in creating responsible organisations and governments".

Dr McCullough said the UK and Northern Ireland ethical advice and support frameworks "set out the principles to be adopted in a pandemic including adult social care".

The north's guidance includes "care homes have an obligation to protect, through effective infection prevention and control measures, the vulnerable populations under their care" and "all residents should be offered high quality and compassionate care, recognising that every person and their human rights, personal choices, safety and dignity matters".

Dr McCullough said instead "frontline staff in hospitals, primary care, care homes, and the community have all had to contend with shortages".

"No one was prepared for the PPE required to fight this pandemic, but, there seems to have been a lack of procedural justice in the ethical allocation of protective gear and Covid-19 testing.

"Would the families of the many vulnerable people in our society who died form the virus say the allocation of PPE and testing was reasonable, respectful, inclusive, or proportionate?"

She warned the scale of loss of life from "lack of protection relating to mis- or non-prioritisation of PPE and testing for these extremely vulnerable people, carers and staff, continues to infringe their human rights and equates to a complete and dangerous lack of respect. It is unethical."

The National Care Forum published findings that around one in eight care home residents in England have still not been tested for Covid-19.

There are no statistics for testing rates in Northern Ireland care homes and Dr McCullough said there is "a need for straight answers as to why the most vulnerable were left unprotected and untested for such a prolonged period of time, even until now".

She said with suggestions of a second wave authorities "decisions need to be justified, including how and why they were made, with accompanying records to provide evidence".