Saturday, 7 April 2012

Liverpool Care Pathway – Protecting The Victim

On the manner of Shipman's death, Wikipedia reports:

Death Harold Shipman committed suicide by hanging in his cell at Wakefield Prison at 06:20 on 13 January 2004, on the eve of his 58th birthday, and was pronounced dead at 08:10. A Prison Service statement indicated that Shipman had hanged himself from the window bars of his cell using bed sheets.[24] 

The Guardian headlined -

How do you protect the living dead?

Some hope of release might have prevented Dr Shipman's suicide
    Yesterday's terse announcement from Prison Service headquarters, that the convicted mass murderer Dr Shipman had hanged himself in his cell at Wakefield prison, prompts many more questions than the simple one of "How could it happen?" We have been told that, at the time, the authorities at Wakefield did not believe there was any risk that he might commit suicide. Instead of being put under special suicide watch every 15 minutes, he remained at the standard one-hour's watch for all high-risk category A prisoners. No prison in the system is more experienced at looking after high-risk prisoners than Wakefield. Therefore, it must be presumed that staff acted in good faith, and on the best available advice.

Some hope of release? These are commendable concerns. The quality of mercy is not strained; it is a boon offered freely and without compunction.

The Guardian continues -

Coming on top of the suicide of Fred West and the near suicide of Ian Huntley before they were brought to trial, Shipman's death is bound to come as an embarrassment to the Prison Service. Inevitably, it will conduct its own internal inquiry to determine whether any indication may have been missed. However, from the point of view of the public as a whole, it is wholly good that the government has announced that, in future, the prisons and probation ombudsman, Stephen Shaw, will conduct independent inquiries into all deaths in custody. People are naturally suspicious of closed inquiries in which no one is held to blame, because it makes it appear that there is something to hide. The number of issues around the suicide of such a notorious prisoner as Shipman demand that the public is told the whole truth. All those who acted in good faith can have nothing to fear.

The writer asks: How could it happen? We are assured that 'All those who acted in good faith can have nothing to fear'.

A society which does not care is not worthy to be called a society; it is a jungle of each for themselves and be damned to everyone else. Thus, The Guardian headline is commendable and fitting, in accord with that merciful and enlightened attitude of the great social reformers of the 19th century - Elizabeth Fry, Charles Dickens.

And yet, whilst it is well to safeguard the lives of those held in our gaols, what safeguard was there in place to protect their victims?

Would that such measures had been in place to protect them, but it is only possible to know that a victim is a victim after the fact. Only the perpetrator is in a position to control events to bring about a different outcome.

It is well and it is commendable to express compassion - compassion and consideration that these ‘lifers’ serve a life sentence - but their victims have been served a death sentence… 

And the enormity of their crimes prompts questions which do require answers.

The Guardian comments -

There can be nothing more soul-destroying than total and utter hopelessness. In many respects, a natural life tariff is little more than a living death sentence. 

The enormity of their crimes prompts questions which do require answers. It cannot be emphasised enough that they have already served their victims just that - a death sentence!

Assuming these persons are not complete psychopaths, do they have insight into what they have done? Is there some recognition of the magnitude of their crimes?

With recognition, is there remorse?

If there is remorse, is there contrition?

Only through contrition can come redemption, may the victim forgive and might release be considered. Yet, if the perpetrator possessed true insight, would they, could they forgive themselves sufficiently to desire release?

It is the Christian ethic to forgive or to offer forgiveness even in the face of a terrible wrong. Jesus pleads: Father forgive them, for they know not what they do.

Mahatma Gandhi, who forgave his assassin even as he was dying, says: The weak can never forgive. Forgiveness is the attribute of the strong.

These murderers are also tyrants that they may snuff out a life in like manner as they might crush a flower in the palm of their hands. The Guardian leader writer might well consider that in his pleas and exhortations.

What is done is done and cannot be undone; the wrong cannot be righted, but it can be addressed and balanced with charitable acts and works in recognition of the wrong. The desire to follow such a course is a hopeful sign, that there is such recognition.

Such a desire might also be a machination, an act of the clever psychopath to manipulate and to engineer their release.Thus did Hindley manipulate Longford.

Such a desire might not be present.

If there is no such desire and there is only a selfish concern for self and the plight and condition of the self, such as the leader writer himself describes, how may such a person be considered for release back into the community? By implying some complicity or guilt on the behalf of the warders, the writer diminishes the complicity and guilt of the ward.

If these suicides are acts of hopelessness or guilt, the current Death Culture might well soon be urging a program of safe, secure and assisted suicide in our Gaols. In the Case of Shipman, however, we now know that he was a proponent of euthanasia and that his decision to take his own life was a selfless one to make financial provision for his family!

Shipman made 'quality of life' assessments of his patients, considered the financial cost to maintain such a life, and took the appropriate executive decision. The only extraordinary thing about Shipman was the extraordinary dedication with which he did so.

What compassion is there for the innocents who are served a death sentence on the LCP?

How many erroneous 'diagnoses' of dying go unreported? All those, certainly, which are pursued unto death.

How many are put on the LCP without 'benefit' even of a diagnosis of dying?

Those who take such executive decisions to end a life they do not consider as possessing worth or that might cause strain and burden on the family have done so for years prior to its implementation and now do so under the protocols and the protection of the LCP.

Who are these petty executive decision makers that they remove and deny the opportunity to care to family members? What they deem a burden and a strain is a lesson in mercy; it is a privilege, not a burden. It was always a privilege to return to my mother in her elder years the love and the care that she offered me in my junior years.

My mother was not dying. She was not terminally ill. She went in for a period of respite care. But we now know that, even the lack of a 'diagnosis' of dying does not disallow being placed on an end of life protocol such as the LCP...
Despite The Sun's celebration of Shipman's suicide, his death divided national newspapers, with the Daily Mirror branding him a "cold coward" and condemning the Prison Service for allowing his suicide to happen. The Independent, on the other hand, called for the inquiry into Shipman's suicide to look more widely at the state of Britain's prisons as well as the welfare of inmates.[28] In The Guardian, an article by Sir David Ramsbotham (former Chief Inspector of Prisons) suggested that whole life sentencing be replaced by indefinite sentencing as these would at least give prisoners the hope of eventual release and reduce the risk of their committing suicide as well as making their management easier for prison officials.[28] 

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