The eyes and the ears: why Adam blew the whistle

Previously I wrote a dialogue between two junior doctors. They discussed why Michael would not report, to some higher authority, the dangerous incompetence of a consultant. In this second dialogue, Adam explains to his friend why he phoned the GMC to report dangerous staffing levels. This dialogue seeks to illustrate why a doctor might feel... Continue Reading →

The cusp: ethics of the learning curve

  There is a moment in medical training when you think you are ready to go it alone. The difficulty is deciding when that moment has arrived. Independence, working without supervision, is a watershed moment. Imagine this situation. A gastroenterology registrar who believes that she is ready to deal with bleeding ulcers receives a phone... Continue Reading →

An opaque code: the Liverpool Care Pathway and a gap in perception

The independent report into end of life care, ‘MORE CARE, LESS PATHWAY: A REVIEW OF THE LIVERPOOL CARE PATHWAY’ has been published. Eagerly awaited, following months of controversy (click on the category below for other posts) , the report contains a paragraph that at first sight seems somewhat trivial…but which I think holds a key... Continue Reading →

5 days: a tale of escalation creep

Day 1 A 90 year old lady, Mrs V, is admitted to hospital with symptoms of pneumonia. She was managing at home 6 months ago but has become increasingly dependent on her family; the plan was to employ or arrange carers soon. She always said she never wanted strangers around – the words ‘fiercely independent’ are... Continue Reading →

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