Flash Says…

Archive for November 2012

I spend every Wednesday – and every other Monday – scouring certain websites as soon as I wake.

Many years ago I devoured The Railways Archive’s repository of train accident reports – intrigued by those that happened in areas I know well (such as the Taunton Sleeping Car Fire where pupils, from a school I would later attend, gave assistance) and my eyes opened by others, how one simple error could lead to disaster. They were a horrific but fascinating set of reports, often harkening back to a bygone age.

But eventually I read up to the present day, and new reports aren’t published often enough to sate my interest. Then I discovered Ofcom – who manage complaints about TV programmes, publishing fortnightly adjudications in a Broadcast Bulletin – and the Advertising Standards Agency, who make weekly rulings on pesky advertisers. At last I can bury my nose in adjudications on a regular basis! Better still, they are often entertaining.

When I open an Ofcom report, I try to guess why the programmes concerned have caused problems. An unbalanced news report? Swearing on reality TV? Too many adverts on a shopping channel? Revealing too much flesh on a pay TV programme? I delight in the formal descriptions of what exactly happened, the minutiae of the offence.

My favourite complaints are those from individuals, preferably which have not been upheld. Usually these are people whose misbehaviour has been featured in a Watchdog-style exposé, or they took part in reality TV but now regret how they acted and retrospectively claim they never consented to be filmed. Their complaints are often unintentionally hilarious, ridiculous and clearly unfounded.

So that’s what I look forward to reading on a regular basis. What’s your guilty pleasure?

The Liverpool Care Pathway has been in the news lately. It’s a care path for people who are dying, whereby invasive treatment is withdrawn and they are left to die peacefully. At least, that’s the principle. It isn’t what my experience found.

A few years ago, a relative of mine was put on the Liverpool Care Pathway. It was explained to my family that he was expected to die, so invasive treatment would be withdrawn, medicine would be stopped (as it wasn’t working, so it was redundant) and that we would be left in peace to spend time with our relative before the inevitable happened. It was presented as the best, and normal, thing to do, and we numbly went along with it.

Some advantages were clear right away; curtains were pulled around our relative’s bed and a “Do not disturb” sign placed outside, so that we were not interrupted by staff asking whether the patient would be having any dinner. We were given permission to come and go as we wished, beyond regular visiting time – and my family began a vigil so there was always one of us present at the bedside.

The heart monitor, which I’d been watching in a daze, was removed – this was a good thing as I stopped focusing on that, instead focusing on my relative. Medicines were stopped. This was all as expected so far. But then my relative’s feeding drip was removed. We weren’t expecting that! I didn’t consider the drip to be invasive – fair enough if it had fallen out, then I could understand the need to discuss whether it was replaced. But it had at no point been made clear to us that liquids and nourishment would be removed – in contravention of the relative and carer leaflet about the LCP, which refers to maintaining the patient’s comfort, and says decisions about food and drink will be explained and reviewed regularly.

This aspect of the LCP has been in the news recently, with one report saying that a patient even rang the police so he could have a drink of water. Should patients be parched and famished as they die? It seems inhumane, something you wouldn’t even do to a dog! If I’d known that my relative’s nourishment would be removed, I would have challenged putting him on the LCP. If a drip is in place why not leave it? No one wants to die thirsty.

After a few days of our 24 hour vigil, to everyone’s surprise, my relative woke up from his coma. Suddenly treatment was reinstated with all haste. And do you know what? He was hungry.

The Liverpool Care Pathway is about convenience, not about care. In my view it’s about making the time before death easier for the living, and for the medical staff who can then spend their efforts on other patients. That’s not good enough in my view, and I’d never support it again.