Would you? The RCP Assisted Dying survey

  Doctors in England are being asked to answer a survey on their attitudes to assisted dying (AD). The Daily Mirror led on it on their front page today (Monday 14th Jan). The Royal College of Physicians wants to be sure that it current oppositional stance is a true representation of members' views, and is prepared... Continue Reading →

The problem of late-stage consent in Assisted Dying

Assisted-dying law in Canada requires the person to be alert and able to provide consent just before their death. The Government of Canada website on Medical Assistance in Dying (MAiD) says, You must be able to give informed consent both: at the time of your request immediately before medical assistance in dying is provided This seemingly... Continue Reading →

Understanding Gosport

  Many doctors and nurses must be trying to understand what went on at War Memorial Hospital, Gosport, especially those who regularly look after patients who are approaching the end of life. Yet, reading the independent report, its magnitude, complexity and ugliness forced me to look away. With its chronological sweep (27 years), terrifying number... Continue Reading →

Accountability, blame and medical error after Bawa-Garba

  The reaction to the Dr Bawa-Garba case has shown that the medical community finds it hard to accept that individuals can be held personally accountable for underperformance (once we exclude malice, drunkenness or other gross examples). Rather, deficiencies in the healthcare system surrounding the individual should be identified and corrected. Don Berwick was very... Continue Reading →

Justice and safety: a dialogue on the case of Dr Bawa-Garba

  Everyone must have a view. Thousands have expressed theirs. Many have committed to funding an independent legal review. None were there. None heard what the jury heard. Most have read the essentials of the case, and we are worried that if we commit a serious clinical error, we may be ‘hounded’, ‘scapegoated’ or ‘persecuted’, first by the criminal... Continue Reading →

Systems and sense

    The controversy surrounding paediatrician Dr Hadiza Bawa-Garba has got me thinking about the relationship between individuals and systems in healthcare. In this case, it has been suggested that system failures, including under-staffing, contributed to a young patient's death. So important do those factors appear, many feel she should be allowed to continue practising... Continue Reading →

Signature

  What explanation can there be for a surgeon to write his initials on a patient’s liver? It sounds bizarre and disrespectful. This almost surreal, alleged event is sub judice, and I know nothing of the people involved or any details beyond what was in the papers, but perhaps it exposes some interesting psychology. In... Continue Reading →

When death is not the end

This week’s report about a nurse being disciplined for failing to ‘revive’ a clearly deceased nursing home resident, has caused consternation. According to the description given, the woman was ‘yellow, waxy, almost cold’. But a rule mandated that the nurse on duty should commence basic life support and call an ambulance. For her to be... Continue Reading →

Observations on the Emergency Care and Treatment Plan

The Emergency Care & Treatment Plan, developed by the Resuscitation Council, is out for public consultation. It is hoped that going through this with patients or their representatives will lead to fuller discussions and earlier decisions regarding levels of care and resuscitation. Speaking as a clinician, it is a welcome development. It marries two strands... Continue Reading →

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