1/2 I use 'improving dying' in contrast to 'good death' which is what clinicians tend to use: I don't really see death 'as good' and my perspective is that we need to be 'reducing the number of awful deaths'. But - 'improving dying' - making the experience of dying better for
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Replying to @MikeStone2_EoL @Mindyourownyo and
I'm not being rude here but how do you know you are improving dying? Why are you calling it an experience & obsessed with death & not life. Why can't medics follow the Oath and 'do no harm' & 'not play God' & just try to make pts better & if not - they will die in their own time
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Replying to @ang__johnson @Mindyourownyo and
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 @Mindyourownyo @ang__johnson and
Not true either: you can be dying without realising it, you can be dying and you can know it, you can be told that medical opinion is that you are dying [which might be true, or it might not be true] and you might be killed.
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Replying to @MikeStone2_EoL @Mindyourownyo and
25mcg fentanyl= 135mg morpine + 50 mg Chlorpromazine + 40mg Diamorphine + 40 mg midazolam given in 23hrs patient full capacity,no pain whatsoever,no cancer
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Replying to @ann_poppy @Mindyourownyo and
? Full capacity - was consent obtained for the medications? If not - then clearly that was at a minimum 'assault'. Consent is about 'interventions', it isn't just about surgery - as Mr Justice MacDonald has pointed out (see JPG) http://www.bailii.org/cgi-bin/markup.cgi?doc=/ew/cases/EWCOP/2015/80.html&query=court+and+of+and+Protection+and+Justice+and+MacDonald+and+sparkle&method=boolean …pic.twitter.com/ckew6RS3vY
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Spot on. Doesn't require harm, or even physical contact (although that will do it). Some scanning procedures are also considered assault without valid consent.
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Replying to @C7RKY @ann_poppy and
This is why my position is 'the HCPs must get ongoing consent, or correctly [ongoingly] apply the MCA's best-interests process: and, crucially, 'the records' must include the right signatures 'to confirm that' http://www.bmj.com/content/352/bmj.i26/rr-5 …pic.twitter.com/xGjRiiiq6b
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