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michael stone

michael stone

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Comments (2749)

  • Comment on: Terminally ill patients 'need 24/7 support', says charity

    michael stone's comment 19-Oct-2014 12:19 pm

    I know that most nurses 'take patient confidentiality' 'very seriously' - the problem, is the potential conflict between the concept of patient confidentiality, and section 4(6) of the Mental Capacity Act. Mickey Mouse was world superstar, wasn't he ?

  • Comment on: Terminally ill patients 'need 24/7 support', says charity

    michael stone's comment 18-Oct-2014 1:38 pm

    Anonymous | 17-Oct-2014 7:34 pm As you have raised 'patient confidentiality', I will point out that there needs to be a debate about the concept of patient confidentiality as it applies during Last Year(s) of Life, with particular emphasis on 'where balance-points should correctly be set': http://www.bmj.com/content/348/bmj.g4094/rr/703333 http://www.dignityincare.org.uk/Discuss_and_debate/Discussion_forum/?obj=viewThread&threadID=721&forumID=45 http://www.dignityincare.org.uk/Discuss_and_debate/Discussion_forum/?obj=viewThread&threadID=692&forumID=45

  • Comment on: Terminally ill patients 'need 24/7 support', says charity

    michael stone's comment 18-Oct-2014 10:18 am

    Anonymous | 17-Oct-2014 7:34 pm I couldn't identify a specific patient, and neither can you from what I have recounted above. If people who work within the NHS cannot discuss the reality of events on the ground, then the supposed 'transparency' of the NHS doesn't exist, and the public cannot attain the necessary level of information for considered debate/opinion. I can add, that this particular consultant, has got 'a high media profile', and is really angry about the way the press misrepresent what he has said in the past [by quoting selectively and out of context] and then 'attack him for saying it', to the point that he is very reluctant to actually say anything at all ! You avoided discussing the point - which was related to the NT piece this is posted under - of what he did recount, in your comment.

  • Comment on: Hunt appeals to nurses to save NHS money by reducing errors

    michael stone's comment 17-Oct-2014 1:54 pm

    Hunt has got a point. Perhaps he could have a word with other ministers, about the amount of [tax-payers'] money they waste by making errors when trying to purchase IT systems ?

  • Comment on: Terminally ill patients 'need 24/7 support', says charity

    michael stone's comment 17-Oct-2014 1:52 pm

    Anonymous | 16-Oct-2014 7:14 pm I know it is 'against the law' - but the guidance for 999 Services in particular, isn't a good fit to the law (some 'contradictory' ideas about 'safeguarding' seem to come into play, which really complicates things). 999 Services are also not told to default to believing what relatives tell them, if patients are unconscious (and most 999 HCPs are using guidance which is at best muddled, and at worst legally wrong, about verbal refusals of life-sustaining treatments from patients: there are also issues with written Advance Decisions). I was sent this little story a couple of years ago, by a consultant I was discussing end-of-life with - I have been told of other rather similar things which have happened by other sources: 'Today I saw a man in his late 80s whose children are a lawyer and a nurse respectively and the lawyer is the registered welfare deputy. The man lived in a care home. Despite having very clear documented decisions that he was not for further active treatment or admission to hospital, the care home still called the ambulance when he collapsed and the ambulance still conveyed him to hospital and the hospital doctors were not made aware of the decision not to treat so gave him antibiotics. He arrived on my ward and we did discover at that point that there was a deputy and that she and her family didn’t want any more active treatment. Immediately we respected these wishes in full and made them clear to all parties before getting him back to the care home. It can work, but there is not just the issue of doctors and nurses respecting decisions made by proxies or in an ADRT but also being aware that these decisions have been made. And also for the hapless healthcare assistant in a nursing home at 2am who is faced with someone who has collapsed and bashed their face and the ambulance crew who then come out, they need to know 100% that they are on safe ground not conveying the person to hospital or calling the crew and the information needs to be very prominent for all to see. Clearly not what happened here.' I'm not 100% sure what was indicated by 'welfare deputy' (not sure if that meant a welfare attorney, or a court deputy).

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