The only way to get through life is to laugh your way through it. You either have to laugh or cry. I prefer to laugh. Crying gives me a headache

Friday, 18 December 2009

Arrogant Act!

The best thinking has been done in solitude. The worst has been done in turmoil.

The Kerrie Woolterton case is still troubling many doctors as well as lawyers and medical ethicists around the blogosphere. On Dr Grumble's site, the debate on his post 'Any clinician will tell you' is still going strong since 5 December, ie, for the past two whole weeks. I have been watching the debate as it went forwards only to go back to where it started from and it seems that the matter now hangs on whether Kerrie had the capacity to decide when she arrived to hospital. Well, here is the dictionary's definition of capacity:

Capacity:

1. n. The power of receiving or containing; extent of room or space; passive power; -- used in reference to physical things.
2. n. The power of receiving and holding ideas, knowledge, etc.; the comprehensiveness of the mind; the receptive faculty; capability of understanding or feeling.
3. n. Ability; power pertaining to, or resulting from, the possession of strength, wealth, or talent; possibility of being or of doing.
4. n. Outward condition or circumstances; occupation; profession; character; position; as, to work in the capacity of a mason or a carpenter.
5. n. Legal or noral qualification, as of age, residence, character, etc., necessary for certain purposes, as for holding office, for marrying, for making contracts, will, etc.; legal power or right; competency.

Which is really a definition once simplified affirms this Arabic proverb: A man's capacity is the same as his breadth of vision ... So, simply; did Kerrie have that 'Breadth of vision'? And the answer is NO! For how can this woman be deemed to have breadth of vision when presenting to hospital tormented and with self-inflected poison in her stomach?! Surely, the very idea that she had drunk this poison then decided to run to hospital afterwards means that she had no vision to help her make a sound decision! Breadth of vision means having the capabilities that a person in their normal everyday state uses to weigh up argument and make a decision. Even then, we can still make mistakes and Kerrie did not even have this ability at all then given her tormented state! How about also having a deadly dose of poison inside her too?! Drinking poison is not a normal everyday activity for any normal person and for that, if I were a doctor, I would have deemed this young woman not to have capacity based on that alone and would have treated and saved her life.

And despite all the debate, no one considered the impact of the decision to allow Kerrie to die on her family! Surely, a law such as this mental capacity Act 2005 was not meant to inflict life long torment on Kerrie's father by allowing his daughter to die while he probably was sitting in front of the TV at home not knowing what was happening to her 'in hospital'!

I believe that the hardest thing for a parent to bear is when they out live their own children. Indeed, we all sympathise with the parents and families of young people who die because of a terminal illness or even while doing their duty as soldiers who then get killed in action. We feel for those families and parents even though in both cases death is expected to a certain extent. But Kerrie's father's experience with how his daughter was allowed to die 'in hospital' and while surrounded by 'healers' who simply stood by and allowed it to happen is unique! Cruel, savage and harsh 'unique' IMO! That's why the case doesn't want to go away!

Because every way you look at it ... It Hurts!


... and why wasn't this man called when a decision not to treat his daughter was made?! Could Kerrie have been saved by her father's presence comforting and consoling her in her moments of despair? Or at least, could her father been saved the torment had he held his daughter's hand while she died? In any way you look at it, it was cruel not to contact the father to allow him to persuade his own daughter not to commit the act or, have a say in the matter and what to do next .. or , at least, a way to come to terms with this predicament!

And there are some out there who wonder, now that this father has decided to go to court, if he would win that case and be compensated as a result! While I wish this father wins this case because he and his daughter were badly let down by a system that is supposed to 'heal' first and foremost, I wonder if a daughter can be compensated for with all the money in the world?! :-(

It seems this law was passed by people who perhaps have no idea how ordinary people live ... and die! By people of a certain class in society, not neccessarily to do with wealth, but standing wise too. People who perhaps have never, or their children, experienced or been involved in, or witnessed the type of agony Kerrie was under when she took this poison or the agony now being suffered by her father and the rest of those who loved her!

This Mental Capacity Act 2005 is an arrogant Act ... A flawed law! .... It should be revised to stop such cruelty happening again!

... and next time laws like that need to find a way to include the voices of ordinary people and the man and woman on the street before they are passed, and not only the views of those experts who, in a day's work, are left to decide on matters that perhaps have or will never actually matter to them!

We need a 'Jury system' for when laws that affect humanity are being debated and passed!

... I wonder if that Act would have been passed in it's current form had those who originally debated and passed it had access to the current debate on Kerrie's case all over the blogosphere!

Those views of ordinary people like us!


Make no judgements where you have no compassion.

4 comments:

Dr Grumble said...

Drinking poison is not a normal everyday activity for any normal person and for that, I, if I were a doctor, would have deemed this young woman not to have capacity based on that alone and would have treated and saved her life.
____________


If you had been able to make a reasonable case that KW lacked capacity (and I think the case you have made is not unreasonable) no court would have locked you up for battery.

Sam said...

I would have saved her life regardless Dr G, maybe this is partly why I am not a doctor! Then again, I think you would have saved her too - and so would Dr No .. and the very much missed Witch and her black cat.

You see, as you say, this has to do with humanity and not religious diktat for I think the latter would have left a little room for manouver while humanity wouldn't. I like to believe there is still enough humanity out there, indeed, the debate on your site says there is.

... and had the doctors in question saved this young woman's life only to face prison for their act, I wonder what backlash would have resulted from such judgement?! .. and so, I would also like to believe that doing good always wins at the end.

I am not in a position to find out though ... does this make it easier for to talk? :-)

Anonymous said...

I rather think that the doctors concerned were in a much more difficult position than is usually the case in this sort of situation.

It is said that when time is of the essence and information in short supply, judges have generally chosen to risk the the patient’s wrath, rather than risking her death. But in the KW case there was more time than is usual and my guess is that the involvement of the hospital solicitor led to an internal legal directive which rather tied the doctors' hands.

As we were not there it is impossible to know how reasonable it might have been to question KW's capacity. We do know that she was treated nine times before. We do not, I think, know whether or not she gave her consent on those previous occasions. But it seems she did not complain.

And there remains the curious issue of her turning up to hospital even though she wanted to die which, even if this did not actually mean she was ambivalent about wanting to die, should surely have been enough to raise doubts about her capacity sufficient to allow life saving treatment. My own feeling is that this was the fail-safe option that would appear to have been open to those looking after KW.

KW could always have challenged a decision to treat her in the courts. No doctor would have been locked up for making a decision in good faith and if the doctors had been found to be in the wrong she could have taken another overdose with a properly drawn up advance directive. But can you imagine a court colluding with suicide in this way when aiding and abetting suicide is illegal?

Plainly somebody with a terminal illness might want to die after having taken an overdose and the KW case does seem to show that even though that would be suicide doctors could stand by and focus their treatment on keeping the patient comfortable. But this also means that a patient with a terminal illness could arrive in hospital, open a mail order from Dignitas, take the fatal medicine and ask the doctors around to supervise their death. Or is that wrong?

Sam said...

Hi Anonymous

First, it's been a busy Sunday so please excuse me for taking all this time to reply. Then again, your comments are always thought provoking, so, taking a little longer to answer is wiser too - and I like them :-)

"judges have generally chosen to risk the the patient’s wrath, rather than risking her death."

Great! Reassuring ... and how it should be too

"my guess is that the involvement of the hospital solicitor led to an internal legal directive which rather tied the doctors' hands."

?! Even though it was the doctors who called them to start with? Well, if I were a doctor I would still do all I can, regardless of what the lawyers or the trust recommendation, to save the patient if I felt that there was still hope their life can be saved [Patient coming first] - although I know that may not sit well with trusts and their management or that [ not to bring the trust to disrepute] clause if it exists. What do you think would happen to me if I still did that which is now against the management and lawyers decision?

and this bit about KW never complained that she was saved after her 9 previous attempts?! It says a lot! Poor girl!


"But this also means that a patient with a terminal illness could arrive in hospital, open a [mail order from Dignitas :-D], take the fatal medicine and ask the doctors around to supervise their death. Or is that wrong?"

:-) You know, there is an Arabic proverb that says "the worst predicament is one that makes you laugh" and your senario was sooo hilarious, it did make me laugh - soo much, because I could actually see it too! :-D

Why it is also so freightening as considering that Dignitas does exist and also that this KW case happened here in Britain, it seems the world, and Britain, is heading this way for real; legalising and giving people 'right' to self determination, it won't be long before Dignitas can go ahead and start a mail order business for their lethal products! Wow! @@

However, for the time being, this senario is illegal so, no, it can't happen as well as yes, it is wrong because hospitals and doctors are there to heal not to harm [first do no harm] right?

"As we were not there it is impossible to know how reasonable it might have been to question KW's capacity."

But that's the point I was making; that 'anyone' who drinks poison then goes to hospital asking the doctors not to treat them do not have the capacity to make any sound decision. Especially one that would allow them to terminate their life. And so, regardless whether we were there ourselves or not, there should be a protocol to say that anyone who attempts to commit suicide then arrives to the A&E should be treated first regardless whether they have a living will with them or not, then be accessed by experts later IMO. After all, as you say "No doctor would have been locked up for making a decision in good faith"

"KW could always have challenged a decision to treat her in the courts .... she could have taken another overdose with a properly drawn up advance directive. But can you imagine a court colluding with suicide in this way when aiding and abetting suicide is illegal?"

:-D You got me here anonymous! I can't find an answer to this one, Can you? Yould you please share it with me?

You never come back when I ask you something ... this time I hope you do because I reeeeaally want to know ... unless you can't figure it out yourself too of course!