The careless stupidity of socialist medicine again
Grandfather dies in agony because hospital ignored signed declaration stating he didn’t want to be revived
Hospital chiefs have apologised to the family of a terminally-ill grandfather who died in agony after staff tried to keep him alive against his wishes.
Arthur Johnson, 64, had signed ‘do not resuscitate’ forms instructing medics not to revive him if his heart stopped. But after he was rushed to hospital, his relatives were horrified to find a full crash team fighting to keep him alive.
Today they told how his final hours had been spent in agony and demanded to know why the request – authorised by Mr Johnson’s GP – was not adhered to. The hospital which mistakenly tried to save Mr Johnson’s life could now find itself facing legal action as a result.
The case further highlights the increasingly contentious issue of whether terminally-ill patients have a right to die in the manner of their choosing.
Widower Mr Johnson, a retired pottery industry worker, had decided he didn’t want invasive medical treatment earlier this year after being told his chest and heart conditions were terminal. The father-of-five signed a ‘do not resuscitate’ (DNR) document countersigned by his GP and a community matron and wrote farewell letters to his family in Stoke-on-Trent, anticipating a peaceful death.
After his condition deteriorated and he was moved from the local Douglas Macmillan Hospice to University Hospital of North Staffordshire, relatives passed the form to nursing staff.
But his wishes were ignored when he went into cardiac arrest, and family members arrived to find medics crowding around fighting to keep him alive. ‘When we saw the crash team round him, we were horrified,’ said his daughter and carer Tammy Craggs, 27. ‘We said he was a DNR patient and a doctor immediately pulled back from the bed.’
Now the family are demanding answers from the hospital as to why his wishes were not respected. ‘He spent his last three hours in great pain,’ said Mrs Craggs. ‘He was choking and when I tried to give him a hug he cried out in agony. ‘It was terrible to see dad like that and it would have been avoided if they had just given him pain relief and he had gone peacefully. ‘Why the DNR form wasn’t passed to the doctors on his last day is a mystery. If they had carried out his request, I’m sure he would not have suffered.’
A post mortem examination found Mr Johnson died of emphysema and confirmed that a ‘successful’ resuscitation attempt had taken place.
The family are now thought to be considering legal action against the hospital. ‘This is a legally-binding document so I feel it is a very serious breach of my dad’s rights,’ his daughter said.
Mr Johnson, who had 12 grandchildren, had worked in the pottery industry for 40 years.
Stoke-on-Trent South MP Rob Flello, who is supporting the family, said: ‘If a mistake like this can be made, what would happen if it was the other way round and someone needing resuscitation did not get it? ‘The hospital must give assurances on the whole question of DNRs.’
Last night the hospital trust refused to discuss what investigations it was carrying out into the blunder. But a spokesman said: ‘We have met Mr Johnson’s family twice to discuss their concerns and have apologised to them.’
Government guidelines state that patients’ wishes should be taken into account, even at the point of death. Some parts of the country – including London – now have databases formally recording terminally-ill patients’ wishes about whether they would want to be resuscitated.
The British Medical Association and the now-merged Age Concern and Help the Aged both back such schemes, but pro-life groups say it violates the sanctity of life and amounts to a slippery slope to euthanasia.
Mr Johnson signed the DNR form last November after becoming fed up with frequent hospital stays caused by chest infections, his family said. They were told to present it whenever he required medical attention, which they did when he was moved to North Staffordshire Hospital on January 12.
But five days later they were informed he had taken a turn for the worse, only to find him being resuscitated. ‘He wanted to spend his last days peacefully back at the hospice, but instead he spent his final few hours in pain in a hospital bed,’ said Mrs Craggs, a mother-of-two. ‘We want to know why.’
The family are considering legal action.
Junior doctors’ training ‘compromised by consultants who won’t do night shifts’
Junior doctors are having essential training compromised because the NHS is too reliant on them to work night and weekend shifts that should be covered by more experienced consultants, a critical review says.
The report into the impact of EU laws that limit the working hours of doctors concluded that the NHS needed to be redesigned so that consultants worked more flexibly and were more “directly responsible” for patient care around the clock.
Professor Sir John Temple, who conducted the review under the last Government, said that some of the older consultants were reluctant to work later hours and preferred to stick to a standard week.
Sir John examined the impact of the European Working Time Directive, which cut to 48 hours the maximum time that doctors can work. The review said that junior doctors could still receive high-quality training in a 48-hour week, but only if their responsibilities for providing out-of-hours care were reduced.
Sir John said that trainees also suffered from being poorly supervised, and their chances for learning during the day were reduced because they had to fill gaps in rotas. “When gaps appear, the system is breaking down. It’s breaking down more now than it was two years ago,” he said, adding that although rotas were often “compliant on paper”, some doctors were falsifying records.
“Where there are gaps in rotas these are often in the evenings or at night and offer minimal supervision or training opportunities,” the review said. “Trainees are moved from their daytime, more elective [planned] training commitments at very short notice to fill these gaps. Trainees may thus have to sacrifice planned, supervised training opportunities.”
Sir John said that junior doctors “can be left feeling exposed without proper supervision out of hours” and such a reliance on trainees did not happen in most other Western European countries.
The study, ordered by the former Health Secretary, Alan Johnson, to look at training in England, recommended an overhaul of the way that consultants organised their workloads, with greater emphasis on “consultant-delivered care”.
Sir John said that this would cut costs in the long term because of shorter patient stays in hospital, better decision-making, better diagnosis and increased safety.
Professor Ian Gilmore, president of the Royal College of Physicians, said that there had been improvements in recent years: “I think part of the problem is the older consultants still want to turn up at 8am and go home at 6pm, Monday to Friday.”
One study highlighted in the review said that consultant physicians were directly involved in patient care overnight in only 6.1 per cent of teams. Yet evidence from Australia showed that increasing the number of consultants in accident and emergency (A&E) cut admission rates by 27 per cent, complaints by 41 per cent and waiting times by 15 per cent. In Britain, a study at Salisbury Hospital, Wiltshire, found that admission rates fell by a quarter if consultants were more involved in emergency care.
Sir John said that only 10 or 15 A&E departments in England had consultant staffing levels that allowed them to run a 24-hour service at consultant level. Asked if his recommendations would lead to consultants working shifts, Sir John said: “If the clinical situation merits it, then yes. You can have a perfectly acceptable work-life balance around that.”
Andrew Lansley, the Health Secretary, said: “We will not go back to the past with tired doctors working excessive hours, but the way the directive now applies is clearly unsatisfactory and is causing great problems.”
Passive smoking ‘increases the risk of mental health problems’
Since some very strong studies have shown no adverse health effects of passive smoking, the study below must be approached with caution. And the alarm bells really ring when we find that the effects were confined to men. Are male and female brains all that different?
The study is of course epidemiological rather than experimental so there is a lot of room for “holes” in its conclusions. There are three important holes in the study: Taxonomy, direction of causation assumptions and social class measurement.
Taxonomy: The researchers wisely reclassified people who claimed to be non-smokers if they had high levels of nicotine metabolites in their blood and used primarily levels of such metabolites (cotinine) as their classificatory variable. But that does cast something of a pall over their study. All that they really have is the association between mental health and cotinine level. How much of the cotinine level is actually due to passive smoke versus light smoking we do not know. If just some “non-smokers” were in fact light smokers, the whole study falls into a pit. All observed effects could be due simply to the light smokers in the sample.
Causation: The researchers observed a clear gradient between levels of cotinine and mental health. Regular smokers were the maddest. But that exposes the direction of causation assumptions. Mentally ill people regularly use nicotine as a form of self-medication: Almost all mad people smoke. So again we ask whether some of the mentally ill “non-smokers” were in fact light smokers and add the consideration that they may smoke BECAUSE they were mentally ill rather than the other way around.
Social class: An occupational categorization only was used. Education, IQ and income were not considered, even though all have social class implications and are not well correlated with one another. And since dumber people, less educated and poorer people are all more likely to smoke — and presumably associate with similar people who do — that was an omission large enough to leave the results moot all by itself. We may simply be seeing social class effects on mental health
The journal article is “Objectively Assessed Secondhand Smoke Exposure and Mental Health in Adults”
Passive smoking is known to increase a person’s risk of heart disease and lung cancer, now research suggests it could affect mental health as well.
Scientists from the University College of London found that non-smokers exposed to a lot of secondhand smoke were 50 per cent more likely to suffer from psychological distress than those not exposed to other people’s smoke.
Their risk of being admitted to a psychiatric hospital over the next six years was nearly tripled, while it was almost quadrupled for smokers.
The study found the higher a person’s secondhand smoke exposure, the greater their risk of psychological distress
The study found the higher a person’s secondhand smoke exposure, the greater their risk of psychological distress
Passive smoking is very common with one US study finding evidence of secondhand smoke in 60 per cent of non-smokers.
Dr Mark Hamer of UCL said that although the physical effects have been measured there is ‘very limited information’ on how other people’s smoke might affect mental health.
To investigate, Dr Hamer and his colleagues studied 5,560 non-smoking adults and 2,595 smoking adults, none of whom had a history of mental illness.
The study subjects answered questions about psychological distress and admissions to psychiatric hospitals were tracked for six years.
Exposure to secondhand smoke among non-smokers was determined using saliva levels of cotinine, which is formed when nicotine is broken down in the body and is an established marker of nicotine exposure.
A total of 14.5 percent of study subjects reported psychological distress.
According to the investigators, the higher a person’s secondhand smoke exposure, the greater their risk of psychological distress, while the risk was highest for people who were themselves smokers.
People with high exposure to secondhand smoke (those with the highest cotinine levels) who didn’t actually smoke themselves were 62 per cent more likely to report psychological distress than those unexposed to secondhand smoke, while the risk for smokers was 2.45 times greater.
During follow-up, which averaged about six years, 41 people were admitted to psychiatric hospitals. The risk of hospitalization was 2.8 times greater for secondhand smokers compared to people not exposed to secondhand smoke, while it was 3.7 times greater for smokers.
The effects were stronger for never-smokers than for ex-smokers, Dr Hamer noted; the fact that former smokers were able to quit could suggest they were intrinsically less vulnerable to the effects of nicotine.
Dr Hamer said the link remained even after he and his colleagues accounted for social status, alcohol intake and other factors that could influence both the risk of mental health problems and the likelihood of being exposed to secondhand smoke. ‘We did see pretty robust associations that remained after those adjustments,’ he said.
Moreover, Dr Hamer and colleagues note that animal studies have hinted that tobacco may depress a person’s mood and some human studies have also suggested a potential link between smoking and depression.
‘Taken together, therefore, our data are consistent with other emerging evidence to suggest a causal role of nicotine exposure in mental health,’ the investigators concluded in their study that appeared in the Archives of General Psychiatry.
English patriotism now respectable again in England
So far only in connection with football matches, however
Every white van seems to have sprouted one and many houses as well. Now Downing Street has announced that it too will fly the flag of St George above No10 to show support for England’s footballers during the World Cup.
David Cameron said he was sure that people the length and breadth of the United Kingdom would be cheering: ‘Come on England.’
The Government has also written to councils urging them not to be health and safety ‘spoilsports’, and to allow council staff and local businesses to fly the flag.
As the residence of the Prime Minister of the United Kingdom, Downing Street usually flies the Union Flag. But no other home nation has qualified for the tournament in South Africa, which kicks off tomorrow.
In an apparently planted question at Prime Minister’s Questions yesterday, new Tory MP Nadhim Zahawi said: ‘I ask you to do a great thing for the people of England and cut through the bureaucracy and nonsense and fly the flag of England over Downing Street for the duration of the World Cup.’
To cheers from MPs, Mr Cameron replied: ‘There was some question that this was going to have a cost impact but I’ve managed to cut through that and I can say that at no additional cost to the taxpayer the flag of St George will fly above Downing Street during the World Cup.
‘For the purposes of this I’m looking at all the benches here and I’m sure that everyone in this House, no matter what part of the United Kingdom they come from, will be cheering “come on England”.’ …
Mr Cameron has previously vowed to ‘reclaim’ the English flag from the British National Party.
Meanwhile local government minister Grant Shapps has urged councils to take a ‘common sense’ approach to flying the flag. It follows cases in which councils have asked for flags to be taken down on health and safety grounds.
British bureaucratic stupidity on display yet again
You might as well talk to a post as talk to a British bureaucrat
To mow a grass verge containing one of Britain’s rarest orchids once may be regarded as misfortune. To repeat the blunder the following year starts to look like carelessness. But to chop down the same patch of endangered wild flowers three years in a row takes a particular type of bureaucratic clothheadedness.
Yesterday, council bosses admitted they have once again massacred one of the last remaining habitats of the narrow-leaved helleborine – a highly distinctive white wild flower.
The mistake has left conservationists and wildlife enthusiasts astonished and angry. They believe the orchids may never recover at the site.
The orchids are officially classed as one of the world’s most ‘vulnerable’ flowers – meaning they are at high risk of extinction in the wild. They are found at fewer than 80 sites in the UK but most locations do not have enough flowers to ensure their survival.
For more than 50 years, the orchids have grown on a road verge at Mascoombe Bottom in the Meon Valley, Hampshire. The open conditions and south-facing slope make it ideal for the plants, which flower between May and July.
But three years ago Hampshire County Council changed its roadside mowing routine and cut down the flowers before they could set seed – putting the population at risk. The charity Plantlife contacted the council and was given a guarantee the mistake would not happen again.
But the error was repeated last year and this year by the council’s contractors, despite more complaints.
Dominic Price, Plantlife’s species recovery officer, said: ‘When I found out last week that for the third year running the few remaining orchids had been cut before they could flower I was absolutely speechless. ‘This is nothing short of a massacre of one of the UK’s rarest species.’
The council was unable to say how the mistake occurred. But councillor Mel Kendal, executive member for environment, said he ‘will be ensuring the council’s procedure is changed so that all the designated verges of ecological importance, among the 4,000 miles of rural verges we cut, are individually assessed to protect rare species of plantlife.’
More secrecy and indifference to due process from government Warmists
The Oxburgh inquiry did make some limited criticism of the frauds at UEA but basically exonerated them. Steve McIntyre was curious to learn about how they came to their conclusions:
In response to my inquiry asking for a copy of any document setting out the terms of reference of the inquiry, Lord Oxburgh stated:
“I am afraid that I am not able to be very helpful as none of the documents about which you inquire exists”
“The only written record, apart from any notes that individuals may have kept privately but of which I am unaware, is our final report that was agreed unanimously. Similarly the terms of reference were given to me verbally and are encapsulated in the introductory paragraphs of our report.”
In response to a previous inquiry, Kerry Emanuel, a member of the Oxburgh panel, stated:
“As for the written documentation, such as our charge, we were at one point asked not to circulate those, and while that restriction may no longer be in force, I feel a little reluctant to pass those along without checking first. The cleanest way for you to get that material is to ask Ron Oxburgh for it”
See here for more background
Why they love the ritual of recycling
The real purpose of recycling is not to ‘save the planet’ but to remind us how wasteful and destructive we are
‘You should treat people with respect instead of having a bunch of bin inspectors, bin police.’ Eric Pickles, the communities secretary in Britain’s new Lib-Con coalition government, has announced that the government will not be pressing ahead with a ‘bin tax’ or ‘pay-as-you-throw’ schemes designed to charge householders based on the amount of non-recycled waste they dispose of.
Yet Pickles is proposing a new approach that is simply a bit more ‘carrot’ than ‘stick’. (On the same day, however, Bristol city council announced plans to introduce smaller bins and fine residents up to £1,000 if they don’t separate their waste correctly. Plus ça change…) The incentive schemes Pickles is offering in place of a ‘bin tax’, which would reward people for recycling rather than punish them for not recycling, still assume that the tedious business of separating our waste for recycling is the best way of dealing with rubbish. Which it isn’t.
The power to trial pay-as-you-throw schemes was legislated for in the UK Climate Change Act of 2009. Five local authorities were allowed the opportunity to test out the scheme. However, none of them actually tried it. Pickles’ new alternative is based on a different scheme piloted in Windsor and Maidenhead, a local authority west of London. An American company, RecycleBank, is working with the council to offer householders rewards for recycling. Residents sign up for a RecycleBank account and then receive points for how much material they put in their recycling bins. They can then exchange those points for discounts at local shops or give their points, as cash, to charity.
Getting rewarded for doing ‘the right thing’ seems like a pretty good idea. ‘It does not put the costs up’, Pickles told BBC News. ‘Actually, what it does is it increases the recycling rate and puts money into the local economy.’ But this money is not being magicked up out of thin air. Rather it represents the saving made by councils by not having to pay the punitive costs for sending rubbish to landfill because instead they are encouraging local residents to sort the rubbish out. As RecycleBank boss Matthew Tucker told spiked last year: ‘For every tonne that we help a council divert from landfill, we take a percentage of that saving. If the council doesn’t save, we don’t make any money.’ (For a fuller discussion of the pros and cons of recycling, see Recycling: an eco-ritual we should bin, by Rob Lyons).
The saving comes from the severe regime put in place to encourage councils (with a financial gun to their heads) to stop using landfill to dispose of waste. There are two elements to this. Firstly, there is the landfill tax. This is charged on every single tonne of ‘active’ waste (in other words, anything that might decompose, including wood and plastic as well as food) that goes to landfill. The current rate is £48 per tonne. On top of this, councils are also set targets for a maximum total amount of waste going to landfill. If they breach those levels, a fine of £150 per tonne is imposed.
There are numerous other ways to dispose of waste other than landfill and recycling. For example, many more councils in the UK now use incinerators (or, to use the proper parlance, energy-from-waste facilities) to burn waste and generate electricity. If a combined heat and power scheme is tacked on, then the waste heat can also be used to heat local offices, factories and homes. So some councils have quickly built energy-from-waste facilities to get round these fines and taxes.
However, there are also recycling targets imposed by law in addition to the landfill taxes, targets and fines, with the aim that one third of waste will be recycled within five years.
This is Alice-in-Wonderland economics. Landfill is so much cheaper than recycling that in order to get councils to change their waste disposal policies, absolutely swingeing charges must be put on to landfill. Only then does recycling start to make financial sense. Yet with a little ingenuity, we can get most of the benefit of recycling more cheaply and more conveniently.
For example, one of the main justifications for recycling is to cut greenhouse gas emissions. In turn, one of the main sources of such emissions in relation to waste is the methane gas – the same stuff that powers your cooker or central heating – produced when waste rots at the dump. But modern landfill schemes can capture this gas – called biogas – and burning it already makes a small but pretty reliable contribution to UK energy production.
Even recycling itself doesn’t need to be such an almighty pain in the neck. While Pickles and others have highlighted the rewards side of the Windsor and Maidenhead success story, the other element is something called co-mingling. Basically, instead of following endless arcane rules on which kind of rubbish goes into each of the veritable epidemic of multi-coloured containers that local authorities currently provide, with co-mingling there are just three containers: wet waste, like food; dry recyclables, like paper, plastic, card, metals and so on; and everything else. The dry recyclables are then separated out by machine at a depot. The machines aren’t quite as good as doing it all by hand – yet – but they’re still pretty good.
By taking out much of the confusion and hassle associated with separating waste, householders are more likely to do it. This convenient solution, however, doesn’t play well with greens. This is partly because of an obsession with recycling every last iddy-biddy bit of waste. But the main reason why co-mingling irritates greens is because if you take away the complexity of recycling, the ritual of thinking about it and doing it – if it’s barely any more than shoving stuff in the bin, just like it used to be – then we don’t have that daily eco-message drummed into our heads: ‘We are greedy, wasteful people who throw too much stuff away.’
There would be no point in spending lesson after lesson at primary school teaching kids about how to recycle, and why to recycle, if it’s just sticking stuff in the same bin. For greens, the attraction of complex, confusing systems of recycling is that they remind us, as we carry them out, what wasteful and destructive creatures we are. It is more like penance than a practical activity.
When pressed, the more sensible recycling advocates will admit that separating out our waste – like another fashionable idea, banning plastic shopping bags – has little impact on the environment. They will also admit that recycling schemes will always require a certain amount of subsidy. (What’s a few hundred million quid between friends when the national debt is heading rapidly towards a trillion pounds?) Household recycling is a waste of money and time that only makes sense as a form of self-punishment for the eco-sin of consumption.
In other words, those who want us to recycle our rubbish are really trashing us.
British schools failing to teach the Christian foundations of British culture
The Christian religion is the foundation of most of Britain’s culture and traditions. The history of our nation is incomprehensible without some knowledge of it. And yet, as we report today, and as anyone who has school-age children attending a non-religious state school will already know, the rudiments of Christianity are frequently poorly taught — if, indeed, they are taught at all. A report by Ofsted has found that, although nominally required by the national curriculum, in many schools instruction is “superficial”, and is treated less seriously than the study of other religions.
In part, this is a result of a misplaced enthusiasm for “multiculturalism”, and a determination to include other faiths such as Islam, Hinduism, Buddhism and Sikhism, all of which the national curriculum requires pupils to study. But it is also a reflection of the ignorance of many of the teachers themselves. There is, as Ofsted euphemistically puts it, “uncertainty” about what the teaching of Christianity should involve.
That needs to be remedied as soon as possible, and Michael Gove, the Education Secretary, should ensure that it is. Our youngsters have no chance of understanding the history of Britain, or its fundamental values of equality, toleration, and freedom of conscience, unless they also understand where those values came from.
No one is required to adhere to Christianity’s precepts in order to teach them: atheists can do that job quite as well as committed Christians (or Muslims, come to that). But in failing to teach children about the religion of the country they live in, we are depriving them of a critical element in their education.
The hate never dies among British Leftists
“John McDonnell, a Labour leadership candidate, was applauded loudly yesterday for telling a trade union audience that he wished to go back to the 1980s and assassinate Margaret Thatcher.
The MP later said his remarks were intended as a joke but the standing ovation he received underlined how large sections of the party remain tilted to the Left.
Describing himself as a victim of the former Tory Prime Minister’s policies because he worked for the Greater London Council and National Union of Mineworkers, Mr McDonnell said he would be glad to “go back to the 1980s and assassinate Thatcher”.
He appeared the most popular of the five contenders at the leadership hustings at the GMB union’s conference in Southport.
More gun control in Britain?: “Recent events in Cumbria have led to an entirely predictable concern among UK libertarians that even more restrictions on gun ownership and usage are on the way. But on this occasion, I don’t share their pessimism. UK domestic gun legislation is already among the tightest in the world (which is a bit ironic for a country that is one of the world’s largest arms exporters). Furthermore, even the most dyed in the wool statists are currently resigned to having their budgets (and therefore their de facto powers, at least) cut in the short to medium term. These facts, combined with the rarity of shooting sprees in the UK by licensed gun owners using their own weapons, make any attempt to administer further restrictions uneconomic.”