Trust and the NHS

Getting ready for the movers at the end of the week and I Just saw a report about Do Not Resuscitate orders being applied by NHS and care home staff which caught me off guard. My first reaction was a bit of a double take. This is the National Health Service that the UK is supposed to ‘thank’ yet is is carrying out what appears to be a campaign of euthanasia during the SARS/COV-2 pandemic?

Bloody hell, there’s a spur to get private health insurance and no mistake.

First reports started filtering through in April and the situation is ongoing. Care home patients over 65 (and younger) have allegedly been issued with DNR’s without discussion or consultation which is bizarre. A DNR is a voluntary legal agreement, a waiver saying that if the patient suffers from a crisis where breathing or the heart heart is compromised and CPR may be required, life saving treatments will be withheld. See this RT report below.

Being a power of attorney means you have to keep up with this sort of thing and ensure that all is legal and above board. For example, Elderly Friend has a DNR. Not that Canadian medics have paid much attention to it, on one signal occasion they just pitched in and kept her going. More recently, Elderly Friend has had yet another series of falls and we think she’s on the final stretch, Funerals always cast a long shadow and I can feel the darkness creeping up on us. We just hope it’s peaceful.

However, if you have the misfortune to live in certain areas of the UK and an unpleasant rumour has it, have a lighter skin colour, bad luck.

There is something legally very dubious about these reports and it mainly concerns consent. My understanding of the law is that a DNR is a legally framed request by the patient (no-one else) not to resuscitate. A completely voluntary agreement with the patients witting consent. A DNR has to be signed by the patient and countersigned by their POA or next of kin if necessary, to be valid. Otherwise deliberately withholding treatment could be construed as criminal. That part of the law is a necessary safeguard to prevent some ideologically minded sociopath who has weaseled their way into the NHS from doing a Shipman or Munchhausen by proxy on their patients. Medical and care home staff are not allowed to play God or they can be charged with manslaughter or even murder.

Having worked in the UK NHS, the law on consent was drilled into us during training. Treatment beyond that necessary to maintain life, needs consent and DNR’s cannot be imposed because treatments have to be agreed. If this imposed DNR rule is true and is a top down imposed ‘guideline’ from NHS management then those responsible for drafting said policies needs to be held to account. Hanging upside down in the scorpion pit if necessary.

There’s far too much of this ‘implied consent’ business going on in the UK, which makes me pretty leery about spending any prolonged time there. If I was a UK resident I’d opt out of the organ donation side of things as well but I can’t even though I’m a UK passport holder. No UK address you see.

There’s much talk about the NHS being the ‘envy of the world’, which upon examination is just so much propaganda. To be even more blunt, complete bollocks. Canada and the USA, where medical treatment is superior to the UK, make exactly the same claims. The US believes their system is best because you pay for your treatment (or at least your health insurance does) and US doctors are, in my experience generally pretty good, as is their dentistry. North American dentistry I know from experience, is light years better than the UK.

As for being any good, globally the UK NHS trails way behind Taiwan, South Korea, France and Japan. So, the NHS is the ‘best in the world’? Cobblers.

6 thoughts on “Trust and the NHS”

  1. Yes, I take your point about coercion. That was my first reaction when she told me. Certainly where the patient is mentally vulnerable it would be unforgivable.

    In my wifes case, on balance, I prefer to think of it as them offering her an option. One of the possibilities at the time was having her put into an induced coma to give new medication time to work, and she was very much against that happening. Her deterioration is such that she didn’t expect to survive a general anaesthetic; a DNR may have been part of her refusal of that treatment.

    Your reference to having next-of-kin to countersign is interesting, though. That part didn’t happen, as neither her son or I were present at the time.

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    1. Countersigning must happen where dementia is present or suspected, or it is suspected that the signer may have a form of mental illness. Alternatively, two doctors had to approve. Doctors that is, not care home administrators or nurses.

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      1. No sign or suspicion of dementia, and there are plenty of doctors kicking around in the average NHS hospital!

        She is at home at the moment, avoiding the next medical trip for as long as possible, The NHS is quite good at dealing with an emergency; it’s things that last more than a day that they are not so good at.

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  2. My wife has been into NHS hospitals for emergency treatment for the symptoms associated with emphysema at least a dozen times in the last three years. Last year they presented her with a DNR and asked her to sign it, which she did. It was not something she suggested, but was content to go along with it, knowing what it was.

    Her general health is such that I doubt she would survive any attempt at resuscitation anyway. Lack of breathing is the obvious problem, but her generally poor health means that a heart attack is a significant risk (resting heart rate 110 on a good day). A DNR is probably the kindest option, and she would not have thought to ask for one.

    However, if she is ever in a situation where resuscitation is an option and she is not actually in the hospital, I suspect that any passing paramedic will try to bring her back. Even if I’m there to tell them about the DNR, will they believe me? There won’t be time to ‘phone Central Records, and I don’t have a copy of the “contract”. There will be broken bones….

    I hear that some people go for a “DNR” tattoo on the chest, just so there is no ambiguity.

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