The Special Committee Investigating Deaths Under Anaesthesia (SCIDUA) is an expert committee appointed by the Minister for Health under Section 20 of the NSW Health Administration Act 1982.
Established in 1960, the SCIDUA is the longest serving committee of its kind in the world, and has contributed to the impressive reduction in mortality attributable to anaesthesia in Australia.
Since its inception, SCIDUA has received notification of more than 10,000 deaths. In the overwhelming majority of these cases (approximately 95%), investigations reveal that the death was not in any way attributable to the anaesthesia.
The SCIDUA Committee
The Committee is known as the Special Committee Investigating Deaths Under Anaesthesia (SCIDUA) and is an expert committee appointed by the Minister for Health. Its Terms of Reference PDF ~12kb are to subject all deaths occurring while under, as a result of, or within 24 hours after the administration of anaesthesia to peer review so as to identify any areas of clinical management where alternative methods could have led to a more favourable result.
The Committee's documents are privileged from subpoena under Section 23 of the NSW Health Administration Act 1982 DOC ~34kb. Confidentiality of all communications between the reporting anaesthetist and the Committee is paramount
"In other words, they investigate deaths under anaesthesia, get the story from the anaethesist involved, BUT THEY ARE PRIVILEGED FROM SUBPOENA? WHY? Can anyone answer this question. I have one very strong possibility - to prevent LAWSUITS. "
Wednesday, September 15, 2010
NSW PUBLIC HOSPITALS WORST FIGURES FOR MEDICAL ERROR IN AUSTRALIA
NSW: Public Hospitals in NSW have the worst figures for medical error in the country
New Productivity Commission figures on ''sentinel events'' - severely harmful incidents that occur due to a failure of hospital systems - showed 59 cases in NSW, compared with 28 in Victoria, the next worst-performing state, and 147 nationwide.
Even accounting for NSW having the largest population and the largest number of hospital admissions, the figures still show the state performing worse than the rest of the country.
The data showed:
18 NSW procedures involving the wrong patient or body part (29 total, nationally);
19 NSW cases of medical instruments being left in patients after surgery (37 total, nationally);
medication errors in NSW killing 17 patients (29 total, nationally).
New Productivity Commission figures on ''sentinel events'' - severely harmful incidents that occur due to a failure of hospital systems - showed 59 cases in NSW, compared with 28 in Victoria, the next worst-performing state, and 147 nationwide.
Even accounting for NSW having the largest population and the largest number of hospital admissions, the figures still show the state performing worse than the rest of the country.
The data showed:
18 NSW procedures involving the wrong patient or body part (29 total, nationally);
19 NSW cases of medical instruments being left in patients after surgery (37 total, nationally);
medication errors in NSW killing 17 patients (29 total, nationally).
Palliative Care Patient Deaths
Coroner re-sends Tocumwal hospital deaths to DPP
By court reporter Jamelle Wells
The New South Wales coroner has made a number of recommendations after hearing more evidence about the deaths of two patients in Tocumwal Hospital on the New South Wales-Victorian border.
The inquest into the deaths of palliative care patients Ralf Grenfell in 2005 and Bob Cooling in 2007 was adjourned in March last year when Coroner Mary Jerram referred the matter to the Director of Public Prosecutions.
The DPP decided at the time to take no action.
The inquest heard that before they died, Dr Balaji Rao gave both men the muscle relaxant Atracurium, which stops a patient from breathing.
The drug is normally only used as an anaesthetic in conjunction with breathing machines.
The coroner also heard that since 2007, the Greater Southern Area Health Service has changed its drug administration and security and increased its palliative care training.
After the inquest resumed in Sydney on Tuesday to consider additional evidence from hospital staff, the coroner again referred the matter to the DPP.
Ms Jerram also recommended the Department of Health:
Issue a health safety notice warning all medical practitioners and nursing personnel of the potential negative effects of neuro-muscular blocking agents and that those agents should not be used without appropriate ventilator support.
That the department take steps to promote services and advice available from clinical nurse consultants and clinical nurse specialists in palliative care and pain relief. Those steps should include the monitoring, on an annual basis, of the use of those services throughout the state in non-metropolitan hospitals which rely on general practitioners for the provision of medical services.
That the department undertake a review, in conjunction with the NSW Nurses Association and other industry participant groups, of the support processes for whistleblower staff.
That the department reviews its education and training programs for health professionals and support staff with a view to ensuring there is a significant emphasis and focus on:
their role as advocates for clients of the health system;
the role of each person when a complaint has been made.
ABC.net.au
By court reporter Jamelle Wells
The New South Wales coroner has made a number of recommendations after hearing more evidence about the deaths of two patients in Tocumwal Hospital on the New South Wales-Victorian border.
The inquest into the deaths of palliative care patients Ralf Grenfell in 2005 and Bob Cooling in 2007 was adjourned in March last year when Coroner Mary Jerram referred the matter to the Director of Public Prosecutions.
The DPP decided at the time to take no action.
The inquest heard that before they died, Dr Balaji Rao gave both men the muscle relaxant Atracurium, which stops a patient from breathing.
The drug is normally only used as an anaesthetic in conjunction with breathing machines.
The coroner also heard that since 2007, the Greater Southern Area Health Service has changed its drug administration and security and increased its palliative care training.
After the inquest resumed in Sydney on Tuesday to consider additional evidence from hospital staff, the coroner again referred the matter to the DPP.
Ms Jerram also recommended the Department of Health:
Issue a health safety notice warning all medical practitioners and nursing personnel of the potential negative effects of neuro-muscular blocking agents and that those agents should not be used without appropriate ventilator support.
That the department take steps to promote services and advice available from clinical nurse consultants and clinical nurse specialists in palliative care and pain relief. Those steps should include the monitoring, on an annual basis, of the use of those services throughout the state in non-metropolitan hospitals which rely on general practitioners for the provision of medical services.
That the department undertake a review, in conjunction with the NSW Nurses Association and other industry participant groups, of the support processes for whistleblower staff.
That the department reviews its education and training programs for health professionals and support staff with a view to ensuring there is a significant emphasis and focus on:
their role as advocates for clients of the health system;
the role of each person when a complaint has been made.
ABC.net.au
Sunday, September 12, 2010
MEDICAL NEGLIGENCE IN AUSTRALIA WHAT EVERY PATIENT SHOULD KNOW
From the medneg.com.au website. Some interesting facts:-
HOW MANY PEOPLE ARE AFFECTED?
Australia has the highest rate of medical error in the world according to the World Health Organisation :-
18,000 people may die every year in hospitals through preventable medical negligence in Australia
50,000 people suffer from permanent injury annually as a result of medical negligence in Australia.
80,000 Australian patients per year are hospitalised due to medication errors.
HOW MANY PEOPLE ARE AFFECTED?
Australia has the highest rate of medical error in the world according to the World Health Organisation :-
18,000 people may die every year in hospitals through preventable medical negligence in Australia
50,000 people suffer from permanent injury annually as a result of medical negligence in Australia.
80,000 Australian patients per year are hospitalised due to medication errors.
Sunday, September 5, 2010
Medical Negligence in Australia
I ask you all to sign this petition to make medical professionals guilty of medical negligence to be made criminally responsible for acts of negligence performed in public hospitals in Australia.
The Australian Govt has conveniently prevented Doctors etc from being held criminally responsible for negligent acts in their course of duty, in order to prevent lawsuits left and right in this country. In my opinion this is unfair, in other words, a doctor can in effect maim, permanently injure or cause death because of negligent omissions or acts and they are not being made accountable or criminally charged for involuntary manslaughter.
To really put this into perspective for instance, with the current OH&S laws, if a site manager on a building site does not ensure safety practices or equipment are available onsite, and someone falls off ie: scaffolding and dies, they may be charged with involuntary manslaughter.
How is it that medical professionals are allowed to commit negligent acts and are protected by the slack laws in place in Australia today?
You have the power to change this, SIGN THIS PETITION
http://www.gopetition.com/petition/38895.html
The Australian Govt has conveniently prevented Doctors etc from being held criminally responsible for negligent acts in their course of duty, in order to prevent lawsuits left and right in this country. In my opinion this is unfair, in other words, a doctor can in effect maim, permanently injure or cause death because of negligent omissions or acts and they are not being made accountable or criminally charged for involuntary manslaughter.
To really put this into perspective for instance, with the current OH&S laws, if a site manager on a building site does not ensure safety practices or equipment are available onsite, and someone falls off ie: scaffolding and dies, they may be charged with involuntary manslaughter.
How is it that medical professionals are allowed to commit negligent acts and are protected by the slack laws in place in Australia today?
You have the power to change this, SIGN THIS PETITION
http://www.gopetition.com/petition/38895.html
Sunday, August 22, 2010
Tresna Cullen - "It's time Medical Negligence Laws in Australia are changed"
I would like to introduce you to a new friend of mine - Tresna Cullen, both of us united in tragedy at the loss of our loved ones through medical negligence by doctors still practising in NSW.
Tresna suffered the ultimate heartbreak by losing her daughter Jessica after presenting to a hospital with pain and pre-eclampsia symptoms in her eighth month of pregnancy that wasn't discovered on time and wasn't treated appropriately.
Another victim of a nation's shame. Another victim of a decrepit, deceitful and inadequate health system who victimise patients who dare complain and protects those who are negligent in their duties to preserve and sustain life by practising medicine.
Not good enough Australia, these same idiots are still practising medicine possibly treating your loved ones and through this corrupt system are taught to hide their mistakes at the expense of life and YOUR TAXES to pay for their incompetence.
"Tresna and I have discussed our respective stories and I will be joining Tresna's push to get medical negligence laws changed in this country, so these so called professionals will no longer be allowed to maim and cause death because of their own incompetence."
To read Tresna's story and the shocking state of what's happening in NSW Public Hospitals
http://www.dailytelegraph.com.au/news/patients-hospital-horrors/story-e6freuy9-1225840396474
I urge all of you to PLEASE ADD YOUR SIGNATURE Tresna's petition which is linked below
http://www.petitionspot.com/profile/5116435/Tresna_Cullen/
"Don't let Australia's public hospitals become human Abattoirs. Make the butchers accountable for their negligence." Medical Negligence Petition coming soon......
Tresna suffered the ultimate heartbreak by losing her daughter Jessica after presenting to a hospital with pain and pre-eclampsia symptoms in her eighth month of pregnancy that wasn't discovered on time and wasn't treated appropriately.
Another victim of a nation's shame. Another victim of a decrepit, deceitful and inadequate health system who victimise patients who dare complain and protects those who are negligent in their duties to preserve and sustain life by practising medicine.
Not good enough Australia, these same idiots are still practising medicine possibly treating your loved ones and through this corrupt system are taught to hide their mistakes at the expense of life and YOUR TAXES to pay for their incompetence.
"Tresna and I have discussed our respective stories and I will be joining Tresna's push to get medical negligence laws changed in this country, so these so called professionals will no longer be allowed to maim and cause death because of their own incompetence."
To read Tresna's story and the shocking state of what's happening in NSW Public Hospitals
http://www.dailytelegraph.com.au/news/patients-hospital-horrors/story-e6freuy9-1225840396474
I urge all of you to PLEASE ADD YOUR SIGNATURE Tresna's petition which is linked below
http://www.petitionspot.com/profile/5116435/Tresna_Cullen/
"Don't let Australia's public hospitals become human Abattoirs. Make the butchers accountable for their negligence." Medical Negligence Petition coming soon......
Sunday, August 15, 2010
HCCC, The Coroner, St Vincent's Hospital and the first Anniversary of Mato's death
Tuesday marks the first anniversary of my father's death at the hands of St Vincent's Hospital in Darlinghurst. I have been keeping the details under wraps on this blog for legal reasons.
But what I will say is that our family watched firsthand my father die due to a number of errors on that night and I have been trying to have this matter investigated by the HCCC (Health Care Complaints Commission) and those who failed their duty of care to my father on that night made accountable.
After a year of trying to get answers from St Vincent's, the HCCC and the Coroner who by the way has advised me that they simply dont have enough resources, I have still not been given an answer as to why my father died on the 17th of August 2009.
It seems that in NSW there are simply not enough resources for the State Coroner to devote to those who's deaths are questionable, medical professionals are not made accountable for breaching a hospital's own procedures (the Hospital has admitted this) and the HCCC who believe that hastening a man's death by undergoing a procedure in a public hospital is not outside normal practicing procedures under anaesthetic to warrant disciplinary action.
The public health system in Australia is a disaster. For the aged and those that are terminally ill, pray to god you die before you put your faith in the public health system. I have received nothing but stumbling blocks in my quest to gain justice for my father.
It seems that medical professionals are exempt and untouchable for being held accountable for their errors, that in my father's case, cost him his life. Terminally ill or not, this was not a decent way for any human being's life to end.
In my own profession, if I cause serious errors, it may cost me my job. Yet if you are a Dr who performs a procedure without obtaining informed consent, breaching hospital procedures and not monitoring the patient who's life is in your hands, you are protected by the Government bodies who's job it is to improve people's lives and to ensure you receive the treatment YOUR TAXES PAY FOR.
Why do Australians cop this from those who we elect to act in our best interests? Why do we allow those who are considered to serve the community and who supposedly choose to undertake one of the more respected and honoured professions be allowed to be ensconsed in a layer of protection from prosecution from the legal system by the medical mafia in cohorts with the Government who wish to hide the shocking state of our public hospital system and their own incompetence, lack of funding and failure to provide a good public health system in a supposed first world country?
This is why I would support a private health system and a dismantling of the public health system, this would mean accountability, a high level of service and alot of buerocrats out of work.
The US have got it right, I wouldn't mind paying a $15 copay for a top class level of healthcare where the possiblity of litigation makes sure the i's are dotted and their t's are crossed.
But what I will say is that our family watched firsthand my father die due to a number of errors on that night and I have been trying to have this matter investigated by the HCCC (Health Care Complaints Commission) and those who failed their duty of care to my father on that night made accountable.
After a year of trying to get answers from St Vincent's, the HCCC and the Coroner who by the way has advised me that they simply dont have enough resources, I have still not been given an answer as to why my father died on the 17th of August 2009.
It seems that in NSW there are simply not enough resources for the State Coroner to devote to those who's deaths are questionable, medical professionals are not made accountable for breaching a hospital's own procedures (the Hospital has admitted this) and the HCCC who believe that hastening a man's death by undergoing a procedure in a public hospital is not outside normal practicing procedures under anaesthetic to warrant disciplinary action.
The public health system in Australia is a disaster. For the aged and those that are terminally ill, pray to god you die before you put your faith in the public health system. I have received nothing but stumbling blocks in my quest to gain justice for my father.
It seems that medical professionals are exempt and untouchable for being held accountable for their errors, that in my father's case, cost him his life. Terminally ill or not, this was not a decent way for any human being's life to end.
In my own profession, if I cause serious errors, it may cost me my job. Yet if you are a Dr who performs a procedure without obtaining informed consent, breaching hospital procedures and not monitoring the patient who's life is in your hands, you are protected by the Government bodies who's job it is to improve people's lives and to ensure you receive the treatment YOUR TAXES PAY FOR.
Why do Australians cop this from those who we elect to act in our best interests? Why do we allow those who are considered to serve the community and who supposedly choose to undertake one of the more respected and honoured professions be allowed to be ensconsed in a layer of protection from prosecution from the legal system by the medical mafia in cohorts with the Government who wish to hide the shocking state of our public hospital system and their own incompetence, lack of funding and failure to provide a good public health system in a supposed first world country?
This is why I would support a private health system and a dismantling of the public health system, this would mean accountability, a high level of service and alot of buerocrats out of work.
The US have got it right, I wouldn't mind paying a $15 copay for a top class level of healthcare where the possiblity of litigation makes sure the i's are dotted and their t's are crossed.
Tuesday, August 10, 2010
Not satisfied with the care your loved one is receiving in Palliative Care?
I have received a few emails with stories of unacceptable practices in palliative care facilities in Australia.
This includes: Not feeding patients who are too weak to feed themselves, leaving them in their own excrement as well as nurses not providing the care they should in these facilities.
For those that emailed me. I am very sorry to hear this, I have certainly witnessed this in at least one Palliative Care facility my father was in.
We won't change anything until our voices are heard. I encourage you wholeheartedly to contact the Palliative Care Association in your particular states and share your experiences with them also.
http://www.palliativecare.org.au/
This includes: Not feeding patients who are too weak to feed themselves, leaving them in their own excrement as well as nurses not providing the care they should in these facilities.
For those that emailed me. I am very sorry to hear this, I have certainly witnessed this in at least one Palliative Care facility my father was in.
We won't change anything until our voices are heard. I encourage you wholeheartedly to contact the Palliative Care Association in your particular states and share your experiences with them also.
http://www.palliativecare.org.au/
More ER's Examine How to Incorporate Palliative Care - USA
Article Date: 09 Aug 2010
The Wall Street Journal Health Blog reports on increased discussions about palliative care following a recent New Yorker piece by M.D.-journalist Atul Gawande and a new piece in Slate that examines end-of-life care and the emergency room.
"In Slate yesterday, Joanne Kenen reports on how palliative care plays out in the emergency room, where many of these patients with chronic, terminal diseases are frequent visitors. One of 500 ER patients dies there, and another 3% subsequently die in the hospital after being admitted. ... Emory University Hospital, the Bronx's Montefiore Medical Center and Chicago's Northwest Memorial Hospital are all 'exploring the intersection' between the two fields, integrating palliative care physicians and nurses into the treatment team, when necessary. The emergency room, she writes, 'is one place to start' to change the very 'culture of care' in the U.S., 'doing a better job of caring for patients with slowly worsening chronic disease'" (Hobson, 8/5).
This information was reprinted from kaiserhealthnews.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Health Policy Report, search the archives and sign up for email delivery at kaiserhealthnews.org.
© Henry J. Kaiser Family Foundation. All rights reserved.
The Wall Street Journal Health Blog reports on increased discussions about palliative care following a recent New Yorker piece by M.D.-journalist Atul Gawande and a new piece in Slate that examines end-of-life care and the emergency room.
"In Slate yesterday, Joanne Kenen reports on how palliative care plays out in the emergency room, where many of these patients with chronic, terminal diseases are frequent visitors. One of 500 ER patients dies there, and another 3% subsequently die in the hospital after being admitted. ... Emory University Hospital, the Bronx's Montefiore Medical Center and Chicago's Northwest Memorial Hospital are all 'exploring the intersection' between the two fields, integrating palliative care physicians and nurses into the treatment team, when necessary. The emergency room, she writes, 'is one place to start' to change the very 'culture of care' in the U.S., 'doing a better job of caring for patients with slowly worsening chronic disease'" (Hobson, 8/5).
This information was reprinted from kaiserhealthnews.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Health Policy Report, search the archives and sign up for email delivery at kaiserhealthnews.org.
© Henry J. Kaiser Family Foundation. All rights reserved.
Friday, August 6, 2010
The prodigal palliative care blogger returns!
Yep it's been a long time. I had to take time off to work through my experiences with my father and to commit myself half heartedly to this blog just wasn't fair, but now its time to put my heart and soul back into this blog who's topic remains close to my heart.......
Sunday, November 29, 2009
Australians Dying Badly........
Palliative Care Australia report on a recent national forum recently held in Canberra to discuss end of life issues and the current health system and as I suspected the results aren't great.
Yes Australians are dying badly, our palliative care planning and services are a disgrace generally and Australians facing terminal illness and the prospect of palliative care in this country will face hell on earth. Most experiences including my own as a carer have been and eyeopener, what I saw and experienced in palliative care facillities make me fear for my own mortality and the possibility of facing a terminal illness myself some day a frightening prospect. not just because of facing death but because of the lack of care, being left soiled and coping with pain because staff aren't qualified to provide appropriate pain management let alone know how to best treat my symptoms.
"My criticism here is that the forum was only attended to by medical professionals but they really need to involve the community, carers and those facing palliative care sooner rather than later in these discussions. I know I'd like to have my say also. "
To read the article in full here is the link:-
http://www.palliativecare.org.au/Portals/46/media/Australians%20Dying%20Badly%20-%20PCA%20Media%20Release%205%20Nov%202009.pdf
Yes Australians are dying badly, our palliative care planning and services are a disgrace generally and Australians facing terminal illness and the prospect of palliative care in this country will face hell on earth. Most experiences including my own as a carer have been and eyeopener, what I saw and experienced in palliative care facillities make me fear for my own mortality and the possibility of facing a terminal illness myself some day a frightening prospect. not just because of facing death but because of the lack of care, being left soiled and coping with pain because staff aren't qualified to provide appropriate pain management let alone know how to best treat my symptoms.
"My criticism here is that the forum was only attended to by medical professionals but they really need to involve the community, carers and those facing palliative care sooner rather than later in these discussions. I know I'd like to have my say also. "
To read the article in full here is the link:-
http://www.palliativecare.org.au/Portals/46/media/Australians%20Dying%20Badly%20-%20PCA%20Media%20Release%205%20Nov%202009.pdf
Demand Grows for Palliative Care
Humanistic medicine attracts more doctors
By MARNETTE FEDERIS The Seattle Times
SEATTLE — It was a personal experience that first exposed Dr. Christine Cofer to palliative medicine.
During her late teens, when her father was suffering from metastatic kidney cancer and conventional treatments could no longer help him, he started receiving hospice care.
The nurses and social workers who came into their home were a calming presence during a difficult time, Cofer, an internist, said.
"It was a really positive experience for my family."
When it was time to choose a subspecialty, Cofer, a 42-year-old former substance-abuse counselor, decided to go into palliative medicine.
As demand grows for palliative care, a field focused on alleviating pain and increasing quality of life for seriously ill patients and their families, so does the need to formally train doctors in the subspecialty.
Palliative medicine, which includes hospice care, addresses the physical, psychological and spiritual well-being of patients with advanced diseases and their family members.
Doctors must learn pain-management techniques, how to deal with the emotions of patients and how to work with a team of nurses, social workers and even spiritual advisers.
There are 62 medical-school programs across the country offering such training.
One is the University of Washington School of Medicine which, in partnership with Providence Hospice of Seattle, is piloting the only palliative fellowship program in the state.
Cofer, first physician to participate in the University of Washington program, said her interest in the humanistic side of medicine attracted her to palliative care.
"It was sort of a natural step for me," Cofer said. Palliative medicine "allowed me to practice medicine the way I was taught in medical school — you spend more time with people to talk about the things that contribute to suffering."
Most medical students are exposed to palliative and hospice care in school and in residencies, but until recently, formal training and certification in the field has not been widely available.
Palliative medicine was designated a subspecialty in 2006 by the American Board of Medical Specialties and Accreditation Council for Graduate Medical Education. The board offered the first certification exam last year.
Trainees in the yearlong program must complete a residency in one of 11 specialties that include internal medicine, anesthesiology, family medicine, and obstetrics and pediatrics. They must also train in hospitals, hospice settings and a long-term facility such as a nursing home.
That this type of care is becoming mainstream represents "a sea change for the practice of medicine," said Wayne McCormick, director of the University of Washington's Palliative Medicine Fellowship Program.
Still, many lay people may not know what hospice care is until they have a personal experience with a palliative-care team, he said. And "because it's so patient- and family-centered ... the value becomes palpable when you're actually in the middle of it."
———
(c) 2009, The Seattle Times.
By MARNETTE FEDERIS The Seattle Times
SEATTLE — It was a personal experience that first exposed Dr. Christine Cofer to palliative medicine.
During her late teens, when her father was suffering from metastatic kidney cancer and conventional treatments could no longer help him, he started receiving hospice care.
The nurses and social workers who came into their home were a calming presence during a difficult time, Cofer, an internist, said.
"It was a really positive experience for my family."
When it was time to choose a subspecialty, Cofer, a 42-year-old former substance-abuse counselor, decided to go into palliative medicine.
As demand grows for palliative care, a field focused on alleviating pain and increasing quality of life for seriously ill patients and their families, so does the need to formally train doctors in the subspecialty.
Palliative medicine, which includes hospice care, addresses the physical, psychological and spiritual well-being of patients with advanced diseases and their family members.
Doctors must learn pain-management techniques, how to deal with the emotions of patients and how to work with a team of nurses, social workers and even spiritual advisers.
There are 62 medical-school programs across the country offering such training.
One is the University of Washington School of Medicine which, in partnership with Providence Hospice of Seattle, is piloting the only palliative fellowship program in the state.
Cofer, first physician to participate in the University of Washington program, said her interest in the humanistic side of medicine attracted her to palliative care.
"It was sort of a natural step for me," Cofer said. Palliative medicine "allowed me to practice medicine the way I was taught in medical school — you spend more time with people to talk about the things that contribute to suffering."
Most medical students are exposed to palliative and hospice care in school and in residencies, but until recently, formal training and certification in the field has not been widely available.
Palliative medicine was designated a subspecialty in 2006 by the American Board of Medical Specialties and Accreditation Council for Graduate Medical Education. The board offered the first certification exam last year.
Trainees in the yearlong program must complete a residency in one of 11 specialties that include internal medicine, anesthesiology, family medicine, and obstetrics and pediatrics. They must also train in hospitals, hospice settings and a long-term facility such as a nursing home.
That this type of care is becoming mainstream represents "a sea change for the practice of medicine," said Wayne McCormick, director of the University of Washington's Palliative Medicine Fellowship Program.
Still, many lay people may not know what hospice care is until they have a personal experience with a palliative-care team, he said. And "because it's so patient- and family-centered ... the value becomes palpable when you're actually in the middle of it."
———
(c) 2009, The Seattle Times.
I'm back......
I'm back after a leave of absence following my father's untimely demise. I've been on a rollercoaster guys. I lost my father suddenly and it wasn't due to his Advanced Prostate Cancer but due to medical negligence which occurred at St Vincents Public Hospital in Darlinghurst, Sydney after he went through an Intrathecal Spinal Block procedure to relieve pain.
All I will tell you now is that this matter is with the Health Care Complaints Commission and the State Coroner's Office of NSW.
I would love to hear from those who have lost their loved ones due to medical incompetence/negligence and I will cover this at some point on this blog. I am happy to publish your stories on this blog. Legislation covering this needs to change to make those medical professionals accountable.
All I will tell you now is that this matter is with the Health Care Complaints Commission and the State Coroner's Office of NSW.
I would love to hear from those who have lost their loved ones due to medical incompetence/negligence and I will cover this at some point on this blog. I am happy to publish your stories on this blog. Legislation covering this needs to change to make those medical professionals accountable.
Monday, August 31, 2009
What is wrong with End of Life Care?
What are your perceptions of end of life care? What are your expecations? What have you experienced?
Let's hear your point of view, let's share experiences. Did you have issues with communication between medical staff and yourself/loved ones? Was pain control adequate? Did you feel that palliative care staff were proactive? Did you feel yourself or your loved ones were actively involved in decision making with regards to treatment?
What can we change? What do you want to see improved?
I'd like to invite all readers to share their opinions, thoughts and experiences.
Let's hear your point of view, let's share experiences. Did you have issues with communication between medical staff and yourself/loved ones? Was pain control adequate? Did you feel that palliative care staff were proactive? Did you feel yourself or your loved ones were actively involved in decision making with regards to treatment?
What can we change? What do you want to see improved?
I'd like to invite all readers to share their opinions, thoughts and experiences.
Palliative Care Intervention For Patients With Advanced Cancer Provides Quality Of Life Benefits
ScienceDaily (Aug. 31, 2009) — Patients with advanced cancer who received a palliative care intervention focused on addressing physical and psychosocial issues and care coordination that was provided at the same time as cancer treatment reported improved quality of life and mood but did not experience a significant change in the number of days in the hospital or the severity of their symptoms compared to patients who received usual care, according to a study in the August 19 issue of JAMA.
"Fifty percent of persons with cancer are not cured of their disease; however, with improved treatment even patients with advanced disease may live for years. Providing palliative care concurrent with oncology treatment has been proposed to improve quality of life for patients with advanced cancer," the authors write as background information in the article. Although there are recommended guidelines for palliative care concurrent with cancer treatment (such as chemotherapy and radiation), empirical evidence to support this recommendation has been limited.
Marie Bakitas, D.N.Sc., A.P.R.N., of the Norris Cotton Cancer Center at Dartmouth-Hitchcock Medical Center, Lebanon, N.H., and colleagues conducted a study from November 2003 through May 2008 to determine the effect of a palliative care intervention on quality of life, symptom intensity, mood, and resource use in 322 patients with advanced cancer. Patients were randomized to receive either the intervention, a multicomponent, psychoeducational program conducted by advanced practice nurses and consisting of 4 weekly educational sessions and monthly follow-up sessions until death or study completion (n = 161); or usual cancer care (n = 161). The researchers add that the intervention used a case management, educational approach to encourage patient activation, self-management and empowerment.
A number of assessment tools were used to measure quality of life, symptom intensity and mood. These measures were assessed at the beginning of the study, at 1 month and every 3 months until death or study completion.
During the course of the study, there was no statistically significant difference between the groups regarding the number of participants who received parenteral (by injection) chemotherapy or radiation therapy.
The researchers found that the intervention "demonstrated higher quality of life, lower depressed mood, but limited effect on symptom intensity scores and use of resources in intervention participants relative to those receiving usual cancer care. The intervention had no effect on the number of days in the hospital and ICU, the number of emergency department visits, or anticancer treatment because the proportions of participants in each group receiving these therapies were similar."
In regard to symptom intensity, "there may be little room for improvement because usual care participants also reported relatively low symptom intensity scores compared with patients with advanced cancer in other studies," the authors write. "It may be unrealistic to expect to reduce symptoms further in the setting of progressive disease."
"Institute of Medicine reports, the National Consensus Project for Quality Palliative Care, other consensus panels, and oncology professional societies agree that comprehensive cancer care must incorporate more than state-of-the-art disease-modifying treatment. Comprehensive, high-quality cancer care includes interdisciplinary attention to improving physical, psychological, social, spiritual, and existential concerns for the patient and his or her family," the authors write.
Journal reference:
Marie Bakitas; Kathleen Doyle Lyons; Mark T. Hegel; Stefan Balan; Frances C. Brokaw; Janette Seville; Jay G. Hull; Zhongze Li; Tor D. Tosteson; Ira R. Byock; Tim A. Ahles. Effects of a Palliative Care Intervention on Clinical Outcomes in Patients With Advanced Cancer: The Project ENABLE II Randomized Controlled Trial. JAMA The Journal of the American Medical Association, 2009; 302 (7): 741 DOI: 10.1001/jama.2009.1198
"Fifty percent of persons with cancer are not cured of their disease; however, with improved treatment even patients with advanced disease may live for years. Providing palliative care concurrent with oncology treatment has been proposed to improve quality of life for patients with advanced cancer," the authors write as background information in the article. Although there are recommended guidelines for palliative care concurrent with cancer treatment (such as chemotherapy and radiation), empirical evidence to support this recommendation has been limited.
Marie Bakitas, D.N.Sc., A.P.R.N., of the Norris Cotton Cancer Center at Dartmouth-Hitchcock Medical Center, Lebanon, N.H., and colleagues conducted a study from November 2003 through May 2008 to determine the effect of a palliative care intervention on quality of life, symptom intensity, mood, and resource use in 322 patients with advanced cancer. Patients were randomized to receive either the intervention, a multicomponent, psychoeducational program conducted by advanced practice nurses and consisting of 4 weekly educational sessions and monthly follow-up sessions until death or study completion (n = 161); or usual cancer care (n = 161). The researchers add that the intervention used a case management, educational approach to encourage patient activation, self-management and empowerment.
A number of assessment tools were used to measure quality of life, symptom intensity and mood. These measures were assessed at the beginning of the study, at 1 month and every 3 months until death or study completion.
During the course of the study, there was no statistically significant difference between the groups regarding the number of participants who received parenteral (by injection) chemotherapy or radiation therapy.
The researchers found that the intervention "demonstrated higher quality of life, lower depressed mood, but limited effect on symptom intensity scores and use of resources in intervention participants relative to those receiving usual cancer care. The intervention had no effect on the number of days in the hospital and ICU, the number of emergency department visits, or anticancer treatment because the proportions of participants in each group receiving these therapies were similar."
In regard to symptom intensity, "there may be little room for improvement because usual care participants also reported relatively low symptom intensity scores compared with patients with advanced cancer in other studies," the authors write. "It may be unrealistic to expect to reduce symptoms further in the setting of progressive disease."
"Institute of Medicine reports, the National Consensus Project for Quality Palliative Care, other consensus panels, and oncology professional societies agree that comprehensive cancer care must incorporate more than state-of-the-art disease-modifying treatment. Comprehensive, high-quality cancer care includes interdisciplinary attention to improving physical, psychological, social, spiritual, and existential concerns for the patient and his or her family," the authors write.
Journal reference:
Marie Bakitas; Kathleen Doyle Lyons; Mark T. Hegel; Stefan Balan; Frances C. Brokaw; Janette Seville; Jay G. Hull; Zhongze Li; Tor D. Tosteson; Ira R. Byock; Tim A. Ahles. Effects of a Palliative Care Intervention on Clinical Outcomes in Patients With Advanced Cancer: The Project ENABLE II Randomized Controlled Trial. JAMA The Journal of the American Medical Association, 2009; 302 (7): 741 DOI: 10.1001/jama.2009.1198
Monday, August 17, 2009
Mato Medic 21/1/42 - 17/8/09 Rest in Peace Dad
My father passed away earlier this evening. He finally lost his battle with prostate cancer.
They tried to inject him with something that would numb his leg because of the agony this caused him and it seems trying to bring him some pain relief finally brought him peace.
His body couldn't handle the double anaesthetic he received and according to the Dr that performed the procedure "he had a lack of oxygen". There are still many questions to be answered.
Dad I am so sorry, I thought this would bring you pain relief and a better quality of life for the short time you had left. I didn't realise that your poor, ravaged cancer ridden body couldn't cope with it.
I love you so much and I started this blog in honour of you. I will never give up the fight on prostate cancer and palliative care so that others may be treated better than you were.
They tried to inject him with something that would numb his leg because of the agony this caused him and it seems trying to bring him some pain relief finally brought him peace.
His body couldn't handle the double anaesthetic he received and according to the Dr that performed the procedure "he had a lack of oxygen". There are still many questions to be answered.
Dad I am so sorry, I thought this would bring you pain relief and a better quality of life for the short time you had left. I didn't realise that your poor, ravaged cancer ridden body couldn't cope with it.
I love you so much and I started this blog in honour of you. I will never give up the fight on prostate cancer and palliative care so that others may be treated better than you were.
Friday, August 14, 2009
Euthanasia in the Netherlands
The International Taskforce on Euthanasia and Assisted Suicide report facts on the practice of Euthanasia in The Netherlands (where it is legal):-
The Remmelink Report-- On September 10, 1991, the results of the first, official government study of the practice of Dutch euthanasia were released. The two volume report (6)--popularly referred to as the Remmelink Report (after Professor J. Remmelink, M.J., attorney general of the High Council of the Netherlands, who headed the study committee)--documents the prevalence of involuntary euthanasia in Holland, as well as the fact that, to a large degree, doctors have taken over end-of-life decision making regarding euthanasia. The data indicate that, despite long-standing, court-approved euthanasia guidelines developed to protect patients, abuse has become an accepted norm. According to the Remmelink Report, in 1990:
2,300 people died as the result of doctors killing them upon request (active, voluntary euthanasia).(7)
400 people died as a result of doctors providing them with the means to kill themselves (physician-assisted suicide).(8)
1,040 people (an average of 3 per day) died from involuntary euthanasia, meaning that doctors actively killed these patients without the patients' knowledge or consent.(9)
14% of these patients were fully competent. (10)
72% had never given any indication that they would want their lives terminated. (11)
In 8% of the cases, doctors performed involuntary euthanasia despite the fact that they believed alternative options were still possible. (12)
In addition, 8,100 patients died as a result of doctors deliberately giving them overdoses of pain medication, not for the primary purpose of controlling pain, but to hasten the patient's death. (13) In 61% of these cases (4,941 patients), the intentional overdose was given without the patient's consent.(14)
According to the Remmelink Report, Dutch physicians deliberately and intentionally ended the lives of 11,840 people by lethal overdoses or injections--a figure which accounts for 9.1% of the annual overall death rate of 130,000 per year. The majority of all euthanasia deaths in Holland are involuntary deaths.
The Remmelink Report figures cited here do not include thousands of other cases, also reported in the study, in which life-sustaining treatment was withheld or withdrawn without the patient's consent and with the intention of causing the patient's death. (15) Nor do the figures include cases of involuntary euthanasia performed on disabled newborns, children with life-threatening conditions, or psychiatric patients. (16)
The most frequently cited reasons given for ending the lives of patients without their knowledge or consent were: "low quality of life," "no prospect for improvement," and "the family couldn't take it anymore."(17)
In 45% of cases involving hospitalized patients who were involuntarily euthanized, the patients' families had no knowledge that their loved ones' lives were deliberately terminated by doctors. (18)
According to the 1990 census, the population of Holland is approximately 15 million. That is only half the population of California. To get some idea of how the Remmelink Report statistics would apply to the U.S., those figures would have to be multiplied 16.6 times (based on the 1990 U.S. census population of approximately 250 million).
To read more here is the link:-
http://www.internationaltaskforce.org/fctholl.htm
The Remmelink Report-- On September 10, 1991, the results of the first, official government study of the practice of Dutch euthanasia were released. The two volume report (6)--popularly referred to as the Remmelink Report (after Professor J. Remmelink, M.J., attorney general of the High Council of the Netherlands, who headed the study committee)--documents the prevalence of involuntary euthanasia in Holland, as well as the fact that, to a large degree, doctors have taken over end-of-life decision making regarding euthanasia. The data indicate that, despite long-standing, court-approved euthanasia guidelines developed to protect patients, abuse has become an accepted norm. According to the Remmelink Report, in 1990:
2,300 people died as the result of doctors killing them upon request (active, voluntary euthanasia).(7)
400 people died as a result of doctors providing them with the means to kill themselves (physician-assisted suicide).(8)
1,040 people (an average of 3 per day) died from involuntary euthanasia, meaning that doctors actively killed these patients without the patients' knowledge or consent.(9)
14% of these patients were fully competent. (10)
72% had never given any indication that they would want their lives terminated. (11)
In 8% of the cases, doctors performed involuntary euthanasia despite the fact that they believed alternative options were still possible. (12)
In addition, 8,100 patients died as a result of doctors deliberately giving them overdoses of pain medication, not for the primary purpose of controlling pain, but to hasten the patient's death. (13) In 61% of these cases (4,941 patients), the intentional overdose was given without the patient's consent.(14)
According to the Remmelink Report, Dutch physicians deliberately and intentionally ended the lives of 11,840 people by lethal overdoses or injections--a figure which accounts for 9.1% of the annual overall death rate of 130,000 per year. The majority of all euthanasia deaths in Holland are involuntary deaths.
The Remmelink Report figures cited here do not include thousands of other cases, also reported in the study, in which life-sustaining treatment was withheld or withdrawn without the patient's consent and with the intention of causing the patient's death. (15) Nor do the figures include cases of involuntary euthanasia performed on disabled newborns, children with life-threatening conditions, or psychiatric patients. (16)
The most frequently cited reasons given for ending the lives of patients without their knowledge or consent were: "low quality of life," "no prospect for improvement," and "the family couldn't take it anymore."(17)
In 45% of cases involving hospitalized patients who were involuntarily euthanized, the patients' families had no knowledge that their loved ones' lives were deliberately terminated by doctors. (18)
According to the 1990 census, the population of Holland is approximately 15 million. That is only half the population of California. To get some idea of how the Remmelink Report statistics would apply to the U.S., those figures would have to be multiplied 16.6 times (based on the 1990 U.S. census population of approximately 250 million).
To read more here is the link:-
http://www.internationaltaskforce.org/fctholl.htm
Euthanasia - Dirty word?
Euthansia. Everyone has a different opinion, those for and against. And within what is considered Euthanasia, different types, (BBC quoted):-
Voluntary euthanasia
The person wants to die and says so. This includes cases of:
asking for help with dying
refusing burdensome medical treatment
asking for medical treatment to be stopped, or life support machines to be switched off
refusing to eat
simply deciding to die
Non-voluntary euthanasia
The person cannot make a decision or cannot make their wishes known. This includes cases where:
the person is in a coma
the person is too young (eg a very young baby)
the person is senile
the person is mentally retarded to a very severe extent
the person is severely brain damaged
the person is mentally disturbed in such a way that they should be protected from themselves
Involuntary euthanasia
The person wants to live but is killed anyway.This is usually murder but not always. Consider the following examples:
A soldier has their stomach blown open by a shell burst. They are in great pain and screaming in agony. They beg the army doctor to save their life. The doctor knows that they will die in ten minutes whatever happens. As he has no painkilling drugs with him he decides to spare the soldier further pain and shoots them dead.
A person is seen at a 10th floor window of a burning building. Their clothes are on fire and fire brigade has not yet arrived. The person is screaming for help. A passer by nearby realises that within seconds the person will suffer an agonising death from burns. He has a rifle with him and shoots the screaming person dead.
A man and a woman are fleeing from a horde of alien monsters notorious for torturing human beings that they capture. They fall into a pit dug to catch them. As the monsters lower their tentacles into the pit to drag the man out he begs the woman to do something to save him. She shoots him, and then kills herself.
Where do your beliefs lie? for or against?
Voluntary euthanasia
The person wants to die and says so. This includes cases of:
asking for help with dying
refusing burdensome medical treatment
asking for medical treatment to be stopped, or life support machines to be switched off
refusing to eat
simply deciding to die
Non-voluntary euthanasia
The person cannot make a decision or cannot make their wishes known. This includes cases where:
the person is in a coma
the person is too young (eg a very young baby)
the person is senile
the person is mentally retarded to a very severe extent
the person is severely brain damaged
the person is mentally disturbed in such a way that they should be protected from themselves
Involuntary euthanasia
The person wants to live but is killed anyway.This is usually murder but not always. Consider the following examples:
A soldier has their stomach blown open by a shell burst. They are in great pain and screaming in agony. They beg the army doctor to save their life. The doctor knows that they will die in ten minutes whatever happens. As he has no painkilling drugs with him he decides to spare the soldier further pain and shoots them dead.
A person is seen at a 10th floor window of a burning building. Their clothes are on fire and fire brigade has not yet arrived. The person is screaming for help. A passer by nearby realises that within seconds the person will suffer an agonising death from burns. He has a rifle with him and shoots the screaming person dead.
A man and a woman are fleeing from a horde of alien monsters notorious for torturing human beings that they capture. They fall into a pit dug to catch them. As the monsters lower their tentacles into the pit to drag the man out he begs the woman to do something to save him. She shoots him, and then kills herself.
Where do your beliefs lie? for or against?
Tuesday, August 11, 2009
Palliative Care: A model for innovative health and social policies
From the European Association of Palliative Care
Resolution on palliative care, adopted on 29th of January by the Parliamentary Assembly of the Council of Europe.
Rapporteur: Wolfgang Wodarg
The Parliamentary Assembly of the Council of Europe has unanimously adopted the resolution produced by mr. Wodarg as a part of his report: Palliative care, a model for innovative health and social policies. The report states clearly the need for the development of palliative care in all European countries, to make palliative care available for all patients with life threatening diseases who need it.However, the report does not only support palliative care as a comprehensive approach for severely ill and dying patients.
It commends palliative care as an innovative new way, which can be used as a model for other areas of health care. Setting flexible goals of therapy for the individual patients, and more important, setting these goals in close communication with the patient, as well as supporting the autonomy of the patient and enabling him to experience autonomy even with increasing physical or cognitive impairment are important issues that palliative care can contribute to other areas of health care. In consequence, the report and the explanatory memorandum discuss the importance of ethical concepts such as autonomy or allocation of resources in detail.
The Parliamentary Assembly recommends that member states should promote palliative care as a key pillar of care provision. Rewards for non-product related services should be introduced as incentives to a chieve this. The Assembly also recommends strengthening the contribution from primary More specifically, the Parliamentary Assembly recommends member states to promote symptom control not only in palliative care, but also in the domain of curative medicine, In addition, indicators for progress as well as annual reports should be useful tools for the improvement of palliative care in Europe. There are only few points in the resolution that merit critical discussion.
The report takes into account available surveys on the status of hospice and palliative care in Europe. However, it is based in many parts on the German experiences, and decision makers in other European countries may find it difficult to accommodate all recommendations within the setting of their national health system. Whereas the impact of volunteer work in hospice and palliative care and the need for the involvement of the primary care sector does receive adequate consideration and acknowledgement in the report, the participation of specialized professionals is also of major importance and should not be neglected.
Most general practitioners treat only very few palliative care patients per year, and may lack knowledge and skills to relieve symptoms adequately, deliver psychosocial and spiritual care and coordinate the care for complex cases. In many European countries model projects have demonstrated the efficacy of counselling and care services led by specialists, networking with general practitioners and other carers and service providers in the area. EAPC has given considerable input to the report, from the head office as well as from the Task Force on Development led by Carlos Centeno and David Clark. Information from the Atlas of Palliative Care produced by that Task Force was used as an important resource on the current status of palliative care in the different European regions. We hope that the resolution and the report will archieve wide dissemination, and that it will be used by national governments and by national and regional stakeholders to guide and foster the development of hospice and palliative care. The goal is to make adequate provision of palliative care available to all those who need it, regardless of the economical, social or cultural setting. Setting up a continuous communication with the political structures in Europe will be a major focus of EAPC in the next years to pursuit this ultimate goal.
Prof. Dr. Lukas Radbruch(President of EAPC)
Resolution on palliative care, adopted on 29th of January by the Parliamentary Assembly of the Council of Europe.
Rapporteur: Wolfgang Wodarg
The Parliamentary Assembly of the Council of Europe has unanimously adopted the resolution produced by mr. Wodarg as a part of his report: Palliative care, a model for innovative health and social policies. The report states clearly the need for the development of palliative care in all European countries, to make palliative care available for all patients with life threatening diseases who need it.However, the report does not only support palliative care as a comprehensive approach for severely ill and dying patients.
It commends palliative care as an innovative new way, which can be used as a model for other areas of health care. Setting flexible goals of therapy for the individual patients, and more important, setting these goals in close communication with the patient, as well as supporting the autonomy of the patient and enabling him to experience autonomy even with increasing physical or cognitive impairment are important issues that palliative care can contribute to other areas of health care. In consequence, the report and the explanatory memorandum discuss the importance of ethical concepts such as autonomy or allocation of resources in detail.
The Parliamentary Assembly recommends that member states should promote palliative care as a key pillar of care provision. Rewards for non-product related services should be introduced as incentives to a chieve this. The Assembly also recommends strengthening the contribution from primary More specifically, the Parliamentary Assembly recommends member states to promote symptom control not only in palliative care, but also in the domain of curative medicine, In addition, indicators for progress as well as annual reports should be useful tools for the improvement of palliative care in Europe. There are only few points in the resolution that merit critical discussion.
The report takes into account available surveys on the status of hospice and palliative care in Europe. However, it is based in many parts on the German experiences, and decision makers in other European countries may find it difficult to accommodate all recommendations within the setting of their national health system. Whereas the impact of volunteer work in hospice and palliative care and the need for the involvement of the primary care sector does receive adequate consideration and acknowledgement in the report, the participation of specialized professionals is also of major importance and should not be neglected.
Most general practitioners treat only very few palliative care patients per year, and may lack knowledge and skills to relieve symptoms adequately, deliver psychosocial and spiritual care and coordinate the care for complex cases. In many European countries model projects have demonstrated the efficacy of counselling and care services led by specialists, networking with general practitioners and other carers and service providers in the area. EAPC has given considerable input to the report, from the head office as well as from the Task Force on Development led by Carlos Centeno and David Clark. Information from the Atlas of Palliative Care produced by that Task Force was used as an important resource on the current status of palliative care in the different European regions. We hope that the resolution and the report will archieve wide dissemination, and that it will be used by national governments and by national and regional stakeholders to guide and foster the development of hospice and palliative care. The goal is to make adequate provision of palliative care available to all those who need it, regardless of the economical, social or cultural setting. Setting up a continuous communication with the political structures in Europe will be a major focus of EAPC in the next years to pursuit this ultimate goal.
Prof. Dr. Lukas Radbruch(President of EAPC)
Monday, August 10, 2009
The Dying Process....
I was just reading certain passages from a book written by Julia Lawton called the The Dying Process regarding palliative care from patients points of view and her observations certainly gave me much food for thought and confirmed my own feelings and thoughts on palliative care in this country.
I am not 100% convinced by Palliative Care facilities and principles, it seems the best intentions are in theory correct but are left for too much interpretation and scope which therefore means the kind of palliative care service practiced or given varies from either very good or to very bad.
For instance it seems to me that you have those that are elderly and ill seem to be placed in these facilities who are about to pass and you are wondering if this is a nursing home drive through service? Then you have those with terminal illnesses who are still trying to battle their illness and haven't given up on their lives yet but have no choice because there aren't adequate facilities to have them at home or they require a pain management relief which isn't provided at your garden variety public or private hospital, therefore the policy of the public health system is to dump them into a Palliative Care facility/hospice.
This can't seriously be psychologically good for these type of patients. Imagine having a terminal illness and a will to still live? You are still in control of your mind but may have physical limitations and you are forced into sharing a ward and witnessing the public deaths of others? Not only does the person dying before your very eyes lose their own dignity and privacy as a person, but you have to feel their pain and their indignity also? It's very confronting and seems to prolong your own agony. I could only imagine it would feel like dying countless of times.
And please don't give me the well "nurses and doctors see it all the time". Sure they do, they are trained and paid to do this, but they aren't dying themselves, they go home to their comfortable lives knowing they have their health and families. They go home to forget about it. But when its you or loved one seeing this day in and day out, It would be psychologically devastating, and feeling this sort of depression, it would only exacerbate and be deterimental to your own condition.
It seems the feelings of those going through this are second place to the issues of lack of funding, not enough experienced staff, nurses, and very few doctors whom main concern is to prescribe morphine and then their role is done. Palliative care is to provide comfort and pain relief. But does it really? Is changing the diaper of an incontinent patient really caring? How would this comfort a patient knowing why they are in this morbid atmopshere when they are glued to their bed waiting for death and watching the deaths of others? In fact I would begger to differ on the definition of caring in a palliative care setting from my own experiences.
It seems like the terminally ill and elderly are written off and are left to hide from those the medical profession have deemed incurable from society in a geriatric hospice. You're a social leper.
It seems the terminallly ill aren't encouraged to live the rest of their lives as well as they can, When you are cut off from society, you are no longer included or encouraged into society? Palliative Care facilities don't encourage nor do they give hope to those the most vunerable in society. It's all about waiting to die and changing the sheets of the bed for the next victim.
It's no coincidence that terminal patients who are admitted into these facilities deterioate quickly. In a week a patient who could use a walking frame to walk and who could feed himself can a week later, sleep the entire day, need someone to help him eat and is told they cannot leave their own bed. How can one in this setting possibly try and live as well as they can with the little time they have left?
It seems the psychology is that these people are encouraged to depend on and in most cases lacklustre staff or student nurses on medication, being able to go to the toilet and their very own existance on these people, this way they are easily manipulated and taken care of in nursing terms. They lose themselves to another and aren't given the opportunity to truly live the best they can in the sunset of their lives.
I am not 100% convinced by Palliative Care facilities and principles, it seems the best intentions are in theory correct but are left for too much interpretation and scope which therefore means the kind of palliative care service practiced or given varies from either very good or to very bad.
For instance it seems to me that you have those that are elderly and ill seem to be placed in these facilities who are about to pass and you are wondering if this is a nursing home drive through service? Then you have those with terminal illnesses who are still trying to battle their illness and haven't given up on their lives yet but have no choice because there aren't adequate facilities to have them at home or they require a pain management relief which isn't provided at your garden variety public or private hospital, therefore the policy of the public health system is to dump them into a Palliative Care facility/hospice.
This can't seriously be psychologically good for these type of patients. Imagine having a terminal illness and a will to still live? You are still in control of your mind but may have physical limitations and you are forced into sharing a ward and witnessing the public deaths of others? Not only does the person dying before your very eyes lose their own dignity and privacy as a person, but you have to feel their pain and their indignity also? It's very confronting and seems to prolong your own agony. I could only imagine it would feel like dying countless of times.
And please don't give me the well "nurses and doctors see it all the time". Sure they do, they are trained and paid to do this, but they aren't dying themselves, they go home to their comfortable lives knowing they have their health and families. They go home to forget about it. But when its you or loved one seeing this day in and day out, It would be psychologically devastating, and feeling this sort of depression, it would only exacerbate and be deterimental to your own condition.
It seems the feelings of those going through this are second place to the issues of lack of funding, not enough experienced staff, nurses, and very few doctors whom main concern is to prescribe morphine and then their role is done. Palliative care is to provide comfort and pain relief. But does it really? Is changing the diaper of an incontinent patient really caring? How would this comfort a patient knowing why they are in this morbid atmopshere when they are glued to their bed waiting for death and watching the deaths of others? In fact I would begger to differ on the definition of caring in a palliative care setting from my own experiences.
It seems like the terminally ill and elderly are written off and are left to hide from those the medical profession have deemed incurable from society in a geriatric hospice. You're a social leper.
It seems the terminallly ill aren't encouraged to live the rest of their lives as well as they can, When you are cut off from society, you are no longer included or encouraged into society? Palliative Care facilities don't encourage nor do they give hope to those the most vunerable in society. It's all about waiting to die and changing the sheets of the bed for the next victim.
It's no coincidence that terminal patients who are admitted into these facilities deterioate quickly. In a week a patient who could use a walking frame to walk and who could feed himself can a week later, sleep the entire day, need someone to help him eat and is told they cannot leave their own bed. How can one in this setting possibly try and live as well as they can with the little time they have left?
It seems the psychology is that these people are encouraged to depend on and in most cases lacklustre staff or student nurses on medication, being able to go to the toilet and their very own existance on these people, this way they are easily manipulated and taken care of in nursing terms. They lose themselves to another and aren't given the opportunity to truly live the best they can in the sunset of their lives.
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