Sin to Heal Me ?
Anonymous | 2-Aug-2013 11:14 pm
I'm not sure that George is DEMANDING an apology - I think he has reasonably proved that an apology is WARRANTED however.
The issues with the LCP essentially hinge on who decides 'what is best for the patient' and its objective of palliation of the distress and pain which often accompanies dying. The complications include emotive aspects, and religious versus secular positions about 'who' decides when someone is to be allowed to die. In my opinion, nobody should be challenging a decision which flows from the patient: in the opinion of some, God can do that, and I'd be happier if God did it by putting in a personal appearance instead of working through third parties, if God wishes to dispute the patient's decision.
Mike Stone has very clearly explained the complications of decision making if the patient isn't the decision maker, and I won't repeat that stuff because as Mike has explained, it is complex and takes a lot of description.
Clinicians are surely involved with dying, TO HELP the dying person - if the dying person considers the behaviour of the clinicians to be unhelpful, what more proof does anyone need that the clinicians are almost certainly doing something wrong?
I've been reading about newspapers somewhere - perhaps even in this one.
Potential jurors are also objected to by lawyers on that (unstated) basis: anyone holding a copy of the Daily Telegraph will be assumes right-wing, anyone holding the Guardian will be assumes left-wing, anyone holding the Star will be assumed only looking at the pictures.
These assumptions are not always correct.
Anonymous | 24-Aug-2012 1:33 pm
'It seems currently as though all the changes are taking place willy nilly to the detriment of patient safety and care as well as seriously impacting on the well being of staff and their future in the professional labour market, instead of following some form of coherent planning. this is totally unacceptable.'
That seems to be the problem with 'change' - it isn't quite 'willy nilly', but people pull out just the bits that fit in with their own objectives and existing beliefs, destroy any sort of overall coherence that existed in the original 'vision', and downgrade or ignore any requirements they find inconvenient or difficult.
And many of these plans for change, are based on extending some evidence obtained in one set of circumstances, to quite different situations.
Comment on: End-of-life care pathway 'used to cut costs'
Anonymous | 10-Jul-2012 10:09 am
Anonymous | 10-Jul-2012 10:13 am
Yes, quite !
I read this story in the paper - The Medical Ethics Alliance is a Christian group, with a perspective/agenda it seems.
There is confusion, in what is being reported of their position - i.v. fluid is quite different from drinking a glass of water, etc - and I am not exactly certain what they did write in their paper.
However, some people perceive the LCP and similar as 'killing the patient' - it all looks very dubious, legally and ethically, if clinicians start to decide what a patient wants, without getting that instruction from the patient.
And Adam, will you also place your feedback highlights in this set of postings, if possible - your comments are always interesting.
I have tracked down that NCEPOD report, and the following is included in the foreword, and seems relevant to Adam’s question:
‘This report suggests that today we stand at a crossroads. To the left lies a destiny familiar from America where 60% of us will die in an ICU and we will spend 50% of NHS expenditure in the last six months of life, much of it seeking to postpone the inevitable. This will happen, not because the patient has asked for it or because someone has taken a calculated decision that it is in the patient’s interest to make the attempt, but because the doctors think that they have a duty to do everything that they can to prolong the process of dying.’
The report, which was about resuscitation, also included this comment in the foreword:
‘Alas, the results are profoundly disappointing and as I read these pages I wondered how many of these interventions would be defensible if charged as assaults before the criminal courts, or as professional misconduct before the GMC.’