Officials in New York state, which has been devastated by the coronavirus pandemic, have issued a grim directive to paramedics, urging them not to resuscitate patients that they find without a pulse when they arrive at a scene.
The move has sparked fury amongst first responders, who have said they will continue to try to save lives.
The New York Post reported that paramedics were previously told to spend up to 20 minutes trying to revive people found in cardiac arrest and 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-issued memo.
Outraged frontline medics say the directive goes against every fibre of their role.
"They're not giving people a second chance to live anymore,'' Oren Barzilay, a union boss, told the New York Post
"Our job is to bring patients back to life. This guideline takes that away from us," he said.
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The new guidelines are a further tightening of rules after paramedics were told earlier this month not to transport cardiac patients to hospital if they couldn't revived at the scene.
The new rules mean that paramedics are being urged to not even try to revive patients.
"Now you don't get 20 minutes of CPR if you have no rhythm," a veteran paramedic told the New York Post, referring to cardiac patients without a pulse.
"They simply let you die."
That worker acknowledged only a small percentage of patients without a pulse were ever revived, but to those patients it was "a big deal".
A day after the state's directive was issued, New York's fire department hit back and said they would continue to try and save lives.
The FDNY told emergency-services workers that "the NYC 911 system will continue to maintain a higher level of care", meaning attempted life-saving treatments would continue.