Tuesday, 13 August 2013

Liverpool Care Pathway - 'Informed Consent'

The quality of mercy, oft, is strained and are the vulnerable, so confined, placed at the mercy of others.

This is Los Angeles Times 

After a long and shameful history, California finally banned the forced sterilization of prison inmates and mental patients in the 1970s; two decades later, the state put safeguards in place to make sure the practice didn't resume. But a new report by the Center for Investigative Reporting suggests that despite those laws, at least 148 female inmates underwent tubal ligations between 2006 and 2010 without the required approval by state medical officials.

Many of the women who were sterilized while housed at the California Institution for Women in Corona and Valley State Prison for Women in Chowchilla said they were coerced into agreeing to the procedure, according to the report. That allegation is deeply disturbing. But the fact that such procedures were performed without the mandated approval by a state medical committee is inexcusable.
This is Centre for Investigative Reporting -

Between 1909 and 1964, about 20,000 women and men in California were stripped of the ability to reproduce – making the state the nation’s most prolific sterilizer. Historians say Nazi Germany sought the advice of the state’s eugenics leaders in the 1930s.

In 2003, the state Senate held two hearings to expose this history, featuring testimony from researchers, academics and state officials. In response, then-Attorney General Bill Lockyer and Gov. Gray Davis issued formal apologies.

“Our hearts are heavy for the pain caused by eugenics. It was a sad and regrettable chapter in the state's history, and it is one that must never be repeated again,” Davis said in a statement.

This is 2013, and it is being repeated again.

The Sacramento Bee picks up the report 
Doctors under contract with the California Department of Corrections and Rehabilitation sterilized nearly 150 female inmates from 2006 to 2010 without required state approvals, the Center for Investigative Reporting has found.

At least 148 women received tubal ligations in violation of prison rules during those five years – and there are perhaps 100 more dating back to the late 1990s, according to state documents and interviews.

From 1997 to 2010, the state paid doctors $147,460 to perform the procedure, according to a database of contracted medical services for state prisoners.

Read more here: http://www.sacbee.com/2013/07/07/5549696/female-inmates-sterilized-in-california.html?storylink=lingospot_related_articles#storylink=cpy
Echoing the DoH CQUIN payments to apply the LCP, doctors were ‘paid’ by the State to perform these procedures.

No area of life is exempt. EoLC pathways have permeated every dark corner, every nook and cranny. The LCP has been used in UK prisons...

In another parallel, on The Big Questions, it was stated that the LCP neither prolongs nor hastens death. The LCP was also compared to euthanasia.

This is a description of euthanasia...
"For a case of euthanasia to stay within the law, the medicine must enable the person to die painlessly at or around the same time as they would have otherwise died. In this way the doctor is simply exchanging the cause of death, from a painful one caused by illness to a painless one caused by a medicament." [Wikipedia]
This description of euthanasia might, otherwise, be one of the LCP. It is accepted in this statement that an act of euthanasia is to provide a burden free death - a release from a burdensome death that neither hastens nor postpones death.

Is this Lord Falconer speaking...?
"the killing of the terminally ill [is] not an exception to the law against murder but [is] a lawful act in the interests of the patient." [Wikipedia]

Lord Falconer was recently interviewed on ITV -

Lord Falconer has told ITV News it is up to parliament to legalise assisted suicide for the terminally ill.
The Labour peer is to table a private members bill on the issue.
He said: "People are going to the courts to try to resolve a problem that parliament should be resolving, and that problem is what are the circumstances in which you should be allowed to assist somebody else to die."

The above quotes, cited from Wikipedia, are by Karl Binding.

Binding and Hoche wrote their work, Die Freigabe der Vernichtung lebensunwerten Lebens, in 1920.

Hoche believed [their] ideas would be widely accepted only after, "a change in consciousness, a realisation of the unimportance of a single person's existence compared to that of the entirety... the absolute duty of bringing together all available energy and the feeling of belonging to a greater undertaking" [Wikipedia]
That 'change in consciousness' came quicker than either, probably, anticipated, just ten years later.
"Historians say Nazi Germany sought the advice of the state’s [California] eugenics leaders in the 1930s." - Centre for Investigative Reporting
The world now treads once more those steady but uncertain steps. Hoche's concept (above) echoes the Communitarian Complete Lives and euthanasia in Benelux is already on a roller-coaster to oblivion. This is frightening. Were it only Alton Towers...

Were it only Fawlty Towers and we could get away with mentioning the war...

That is how quickly it happens. Once the mindset is shifted, it doesn't take much grooming to enact the unacceptable to become the acceptable and reasonable.

Since the introduction of the LCP and other death pathways, killing is already become a 'therapy'. And no-one noticed that the killing was actually murder in the case of LCP Mark 8 written in 2003. No test for mental capacity, no consent process...

Where was the consent in the later adaptations?

Eugenics has proceeded with the unborn, those less than 'perfect' and not 'up to standard'. An inquiry into abortion on the grounds of disability has been undertaken.

This is Saving Downs -

It is a momentous and historic moment in our journey to social justice for our community. In the accompanying press release, the Commission of Inquiry says that:
“The UK Government must review the Abortion Act and end the discrimination against unborn disabled children.”
That is pretty clear and direct. This is a clear recognition from a Parliamentary Inquiry that disability selective abortion is discrimination. This is a defining moment for our people as a formal cross-party Commission of MPs and Peers hears and acknowledges the discrimination that has been carried out against our community. Much good will follow from this acknowledgment.
Those so confined are placed at the mercy of others. But where there is 'informed consent', is that consent always informed?

Hysteria and shock-horror reporting takes up the shout against those mentally incapacitated by illness, echoing another era.

This is Deakin -
Deakin’s Professor Megan-Jane Johnstone has examined the ‘Alzheimerisation’ of the euthanasia debate in a new book - ‘Alzheimer’s disease, media representations and the politics of euthanasia: constructing risk and selling death in an aging society’ - based on her extensive research into the media representations of Alzheimer’s and the shift in public attitudes towards euthanasia.

“Alzheimer’s has been portrayed as the ‘disease of the century’ that is poised to have a near catastrophic impact on the world’s healthcare system as the population ages,” Professor Johnstone said.

“This representation of the disease—along with other often used terms such as ‘living dead’, a ‘funeral that never ends’ and a ‘fate worse than death’—places Alzheimer’s as a soft target in the euthanasia debate because it plays to people’s fears of developing the disease and what it symbolises. It positions Alzheimer’s as something that requires a remedy; that remedy increasingly being pre-emptive and beneficent euthanasia.”

Professor Johnstone acknowledges that euthanasia is a polarising and emotive issue, however she warns that the public could be unduly swayed by the way the media, and pro-euthanasia groups, frame the issue as ‘simply a matter of choice’ and through the use of highly personalised, individual experiences.

“Euthanasia is far from a simple matter of choice, as choice itself is no simple matter; it is an extremely complex phenomenon. And Alzheimer’s disease cannot be adequately portrayed through highly publicised individual cases,” Professor Johnstone explained.

“But this is the messaging coming through the media and influencing the public’s perception of Alzheimer’s disease and euthanasia, and calls into question the credibility of public opinion and opinion polls on which future public policy could be considered.”

Professor Johnstone’s book is not a treatise on the arguments for or against euthanasia and does not take a position either way.

“My hope is that the book will open people’s eyes to the ‘Alzheimerisation’ of the euthanasia debate and encourage them to critically evaluate the messages they are receiving from all sides of the debate,” Professor Johnstone said.
‘Alzheimer’s disease, media representations and the politics of euthanasia: constructing risk and selling death in an aging society’ is published by Ashgate Publishing

Choice is never easy and never final.

Death is.

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