1/2 I had a friend who died in a care/nursing home 2008. For the final week of his life, he was permanently delirious and for most of the time 'screaming out in pain'. That leaves awful memories for his family - that is 'an awful death'. BTW - it is CONSENT I'm obsessed with.
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Replying to @MikeStone2_EoL @ang__johnson and
2/2 And I 'do end-of-life' because it was how I was treated by the 999 Services after my mum's death at home, that got me involved in the debate in the first place: I worked out why 'what happened to me, happened' - and the reasons anger me! Your question isn't rude.
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Replying to @MikeStone2_EoL @Mindyourownyo and
(1) It seems that those in pain are not given enough pain relief & those not in pain are given pain relief to be used as a guise to sedate as part of EOL. There are many allegations that many pts were not dying which is what angers me about it. Yes there should be consent
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Replying to @ang__johnson @MikeStone2_EoL and
(2) If they deem a patient as having no mental capacity ( which they can say if they are deeply sedated as an excuse ) eg "The patient is slipping away now and has no capacity" then the medics don't need consent as they will say they are working in the MCA Best Interest of the pt
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Replying to @ang__johnson @Mindyourownyo and
The medics shouldn't normally 'be making the best-interests decisions' - the MCA is more complicated than the medics claim it is.
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Replying to @Mindyourownyo @ang__johnson and
Our judges have made it 100% clear that 'doctor knows best' now only applies to prognoses and treatment: rather like 'pilots can best fly the plane, but the passengers decided where the plane was flying to'. Ditto - NOW [post 'Bolam'] with 'heathcare'.
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Replying to @MikeStone2_EoL @Mindyourownyo and
John Clarke Retweeted John Clarke
Well... post-Bolam ish.https://twitter.com/c7rky/status/938175044177596421 …
John Clarke added,
John Clarke @C7RKYOne of the most important commentary pieces I've ever read on informed consent law. Equally so re judicial deference to doctors: "This approach is in line with Bolam rather than Montgomery & reflects her failure to take on board that the landscape of informed consent has shifted" https://twitter.com/louise_austin12/status/935090031340982272 …Show this thread1 reply 0 retweets 1 like -
Replying to @C7RKY @Mindyourownyo and
Growl - some judges make me angry! Montgomery - and particularly Lady Hale's 'appendix' couldn't really have been much clearer! Montgomery ruling at https://www.supremecourt.uk/decided-cases/docs/UKSC_2013_0136_Judgment.pdf … Lady Hale's 'appendix' is sections 107 onwards.
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Replying to @MikeStone2_EoL @C7RKY and
I'm not sure if this will be readable on Twitter - these sections seemed pretty-clear, when I read the Montgomery ruling (and Fiona Godlee, BMJ Editor, also thought they were pretty clear http://www.bmj.com/content/bmj/350/bmj.h1534.full.pdf … ).pic.twitter.com/ue2mOJuRiu
2 replies 2 retweets 3 likes
I never find my views to be very far removed from those expressed by @fgodlee as a general rule. Although the 'shared decision making' phrase makes a rather uncomfortable appearance in that piece too.
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Replying to @C7RKY @Mindyourownyo and
Ditto - Fiona Godlee's 'views' are usually much closer to mine, than are the positions expressed by some other regular contributors to BMJ.
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