Skip to content
By using Twitter’s services you agree to our Cookies Use. We and our partners operate globally and use cookies, including for analytics, personalisation, and ads.
  • Home Home Home, current page.
  • Moments Moments Moments, current page.

Saved searches

  • Remove
  • In this conversation
    Verified accountProtected Tweets @
Suggested users
  • Verified accountProtected Tweets @
  • Verified accountProtected Tweets @
  • Language: English
    • Bahasa Indonesia
    • Bahasa Melayu
    • Català
    • Čeština
    • Dansk
    • Deutsch
    • English UK
    • Español
    • Filipino
    • Français
    • Hrvatski
    • Italiano
    • Magyar
    • Nederlands
    • Norsk
    • Polski
    • Português
    • Română
    • Slovenčina
    • Suomi
    • Svenska
    • Tiếng Việt
    • Türkçe
    • Ελληνικά
    • Български език
    • Русский
    • Српски
    • Українська мова
    • עִבְרִית
    • العربية
    • فارسی
    • मराठी
    • हिन्दी
    • বাংলা
    • ગુજરાતી
    • தமிழ்
    • ಕನ್ನಡ
    • ภาษาไทย
    • 한국어
    • 日本語
    • 简体中文
    • 繁體中文
  • Have an account? Log in
    Have an account?
    · Forgot password?

    New to Twitter?
    Sign up
C7RKY's profile
John Clarke
John Clarke
John Clarke
@C7RKY

Tweets

John Clarke

@C7RKY

Of course views all mine. All without prejudice. Just a regular chap after all. Oh...and RT's may equally imply ridicule as endorsement.

UK
Joined December 2011

Tweets

  • © 2018 Twitter
  • About
  • Help Center
  • Terms
  • Privacy policy
  • Cookies
  • Ads info
Dismiss
Previous
Next

Go to a person's profile

Saved searches

  • Remove
  • In this conversation
    Verified accountProtected Tweets @
Suggested users
  • Verified accountProtected Tweets @
  • Verified accountProtected Tweets @

Promote this Tweet

Block

  • Tweet with a location

    You can add location information to your Tweets, such as your city or precise location, from the web and via third-party applications. You always have the option to delete your Tweet location history. Learn more

    Your lists

    Create a new list


    Under 100 characters, optional

    Privacy

    Copy link to Tweet

    Embed this Tweet

    Embed this Video

    Add this Tweet to your website by copying the code below. Learn more

    Add this video to your website by copying the code below. Learn more

    Hmm, there was a problem reaching the server.

    By embedding Twitter content in your website or app, you are agreeing to the Twitter Developer Agreement and Developer Policy.

    Preview

    Why you're seeing this ad

    Log in to Twitter

    · Forgot password?
    Don't have an account? Sign up »

    Sign up for Twitter

    Not on Twitter? Sign up, tune into the things you care about, and get updates as they happen.

    Sign up
    Have an account? Log in »

    Two-way (sending and receiving) short codes:

    Country Code For customers of
    United States 40404 (any)
    Canada 21212 (any)
    United Kingdom 86444 Vodafone, Orange, 3, O2
    Brazil 40404 Nextel, TIM
    Haiti 40404 Digicel, Voila
    Ireland 51210 Vodafone, O2
    India 53000 Bharti Airtel, Videocon, Reliance
    Indonesia 89887 AXIS, 3, Telkomsel, Indosat, XL Axiata
    Italy 4880804 Wind
    3424486444 Vodafone
    » See SMS short codes for other countries

    Confirmation

     

    Welcome home!

    This timeline is where you’ll spend most of your time, getting instant updates about what matters to you.

    Tweets not working for you?

    Hover over the profile pic and click the Following button to unfollow any account.

    Say a lot with a little

    When you see a Tweet you love, tap the heart — it lets the person who wrote it know you shared the love.

    Spread the word

    The fastest way to share someone else’s Tweet with your followers is with a Retweet. Tap the icon to send it instantly.

    Join the conversation

    Add your thoughts about any Tweet with a Reply. Find a topic you’re passionate about, and jump right in.

    Learn the latest

    Get instant insight into what people are talking about now.

    Get more of what you love

    Follow more accounts to get instant updates about topics you care about.

    Find what's happening

    See the latest conversations about any topic instantly.

    Never miss a Moment

    Catch up instantly on the best stories happening as they unfold.

    1. Mike Stone‏ @MikeStone2_EoL Jan 13
      Replying to @C7RKY @KaraChrome

      I'm a bit confused by this consent form discussion [I've never signed a consent form]. Can someone tweet an image of an actual consent form, or post a URL to an actual form, so that I can try and see what is being discussed? Seemed to be a URL to an article?

      1 reply 0 retweets 1 like
    2. Kara‏ @KaraChrome Jan 13
      Replying to @MikeStone2_EoL @C7RKY

      I think they vary depending on place & procedure. There's usually quite a lot of small print on them (read & strike out/initial anything you don't agree to) & fair bit of white space for HCP to write in (cross through blank space before signing).

      2 replies 1 retweet 1 like
    3. Kara‏ @KaraChrome Jan 13
      Replying to @KaraChrome @MikeStone2_EoL @C7RKY

      The strike-out recommendations are mine, btw. No-one tells you to do this & some may think it's 'not allowed'. It is. You can shape your consent, but only if you have the knowledge & confidence to do so.

      1 reply 1 retweet 1 like
    4. John Clarke‏ @C7RKY Jan 13
      Replying to @KaraChrome @MikeStone2_EoL

      Right on both counts, imho. DoH delegated discretion to trusts for consent for design, so they vary. And: "People should strike through any blank spaces on the consent form to prevent anything else being written on it - as you would when writing a cheque"http://www.dailymail.co.uk/health/article-3135084/Beware-doctor-asks-sign-terrifying-stories-patients-misled-forms-altered-consent-surgery.html …

      1 reply 0 retweets 0 likes
    5. Mike Stone‏ @MikeStone2_EoL Jan 13
      Replying to @C7RKY @KaraChrome

      1/2 There is also a question of properly 'taking in' a long consent form, at the time you are signing it. The 'delegation to local regions' issue - letting local clinicians figure out what works best - is a good idea if they get it right. It has the benefit of making people

      1 reply 0 retweets 1 like
    6. Mike Stone‏ @MikeStone2_EoL Jan 13
      Replying to @MikeStone2_EoL @C7RKY @KaraChrome

      2/2 think. The disadvantage is some people get the thinking wrong. The other approach - 'imposition of the well-thought-out-from-above' - has the problem that it doesn't encourage local people to question the correctness what is being imposed. Tricky!

      1 reply 0 retweets 1 like
    7. John Clarke‏ @C7RKY Jan 13
      Replying to @MikeStone2_EoL @KaraChrome

      Taking in the consent conversation is a separate, but very valid point. My focus has been on ensuring the record of that conversation remains accurate. Local discretion has its pitfalls. This may help explain a little more. From an email exchange with DoH >pic.twitter.com/rQdhZ3iLr8

      1 reply 0 retweets 0 likes
    8. Mike Stone‏ @MikeStone2_EoL Jan 13
      Replying to @C7RKY @KaraChrome

      The best way to try and ensure that the record of a conversation is 'accurate' is to get whichever party to the conversation did not write the record, to sign the record to confirm that it appears to be right. BMA/RCN/RC(UK) are resistant to that, however.

      1 reply 0 retweets 1 like
    9. John Clarke‏ @C7RKY Jan 13
      Replying to @MikeStone2_EoL @KaraChrome

      Not in this case, it's not. The signature doesn't make a jot of difference in mitigating the risk I'm talking about here I'm afraid - as acknowledged by CQC/NHSE/GMC. If you read the articles I linked to before, it will hopefully explain more.

      1 reply 0 retweets 0 likes
    10. Mike Stone‏ @MikeStone2_EoL Jan 13
      Replying to @C7RKY @KaraChrome

      Ah - you are interested in 'remains' accurate?

      1 reply 1 retweet 1 like
      John Clarke‏ @C7RKY Jan 13
      Replying to @MikeStone2_EoL @KaraChrome

      Exactly! As opposed to the form being vulnerable to later amended, in order to try and justify any clinical action - or inaction - that was not in keeping with the consent obtained.

      4:23 AM - 13 Jan 2018
      1 reply 0 retweets 0 likes
        1. New conversation
        2. Mike Stone‏ @MikeStone2_EoL Jan 13
          Replying to @C7RKY @KaraChrome

          Well - if you design a better form, you would have the problem of the entire form being substituted for a faked one. I suppose you would need to store copies of completed consent forms in a 'trusted third-party repository' as soon as the form was completed? Unlikely to happen.

          1 reply 0 retweets 0 likes
        3. John Clarke‏ @C7RKY Jan 13
          Replying to @MikeStone2_EoL @KaraChrome

          3rd party not necessary. Some measures can prevent amendment, but the greatest protection comes from ensuring that the form makes it clear the pt should take their copy immediately after signing it, imho. Can't switch/amend it unnoticed, if the patient has a copy at home.

          2 replies 0 retweets 1 like
        4. Mike Stone‏ @MikeStone2_EoL Jan 13
          Replying to @C7RKY @KaraChrome

          Keeping a copy makes sense - but all of this (your issue) is about 'distrust' when you think about why it is necessary: distrust is a very poor foundation for good care/behaviour, especially during end-of-life at home [as I keep pointing out, in BMJ rapid responses].

          1 reply 0 retweets 1 like
        5. John Clarke‏ @C7RKY Jan 13
          Replying to @MikeStone2_EoL @KaraChrome

          1/2 You're right, this stems from being given reason to distrust, but it's also about regulation. My mother & I trusted implicitly however, as most do. And it transpires that it's possible to abuse that trust. Potentially systematically & at scale, when you look at the evidence.

          2 replies 0 retweets 0 likes
        6. Mike Stone‏ @MikeStone2_EoL Jan 13
          Replying to @C7RKY @KaraChrome

          1/2 You cannot 'have a process to cover my major issue': an EoL patient at home, explains to a family carer late one evening 'I've now reached the point when I definitely don't want anyone to attempt CPR' but. before that has 'reached the records' the patient arrest and the

          1 reply 0 retweets 0 likes
        7. Mike Stone‏ @MikeStone2_EoL Jan 13
          Replying to @MikeStone2_EoL @C7RKY @KaraChrome

          2/2 family carer calls 999, explaining 'my dad made it clear to me last night, that he doesn't want CPR if his heart has stopped'. Either the 'mindset' is that 999 should believe the carer, or else not - currently it is 'to not believe the carer' which angers me!

          1 reply 0 retweets 0 likes
        8. John Clarke‏ @C7RKY Jan 13
          Replying to @MikeStone2_EoL @KaraChrome

          To use your word from earlier - tricky. Not all families have the same dynamic, so protecting the pt's right to life over the undocumented word of a relative? Yeah... just tricky. Hopefully not too many happen in such a short window like that?

          1 reply 0 retweets 0 likes
        9. Mike Stone‏ @MikeStone2_EoL Jan 13
          Replying to @C7RKY @KaraChrome

          The point is - listening to 'I really would prefer to be dead now. from your dying dad, 'has a deep impact on you': subsequently being 'accused of lying' by 999 leaves you rightly 'furious' if you are [and surely most would be] one of the honest family carers.

          1 reply 0 retweets 1 like
        10. 1 more reply

      Loading seems to be taking a while.

      Twitter may be over capacity or experiencing a momentary hiccup. Try again or visit Twitter Status for more information.

        Promoted Tweet

        false

        • © 2018 Twitter
        • About
        • Help Center
        • Terms
        • Privacy policy
        • Cookies
        • Ads info