Friday, 28 March 2014

Liverpool Care Pathway - Advancing The Will To Live

When every day is a bonus and every hour is a milestone; when every minute is a moment cherished and every second is counted on the clock...

Is it more appropriate to promote the 'Living Will' or to advance the will to live?

It’s instinctual. You see someone in trouble and you rush to their aid. It’s just what you do.

We are not machines. We are not programmed by some machine coded instruction to act or not to act. We are plunged into action by what needs to be done because it's right and because, "A man’s gotta do what a man’s gotta do..."

Was that the all-time action hero, John Wayne...?

It's supposed to be a quote from Stagecoach.

No, it’s in Hondo Wayne says, "A man oughta do what he thinks is right".

Charlton Heston says, "A man must do what he must do" in Three Violent People.

Perhaps we’ll go with Heston, then. It is fitting that we should because he appears with the iconic Edward G Robinson in Robinson's last picture epic, the classic Soylent Green, here mentioned in these pages -
Liverpool Care Pathway – The Protocol Of Choice
It is instinctual. Today's first responders may be trained in the new protocol of DNACPR but, when you arrive on the scene and see every effort frantic being made, what else can you do but throw yourself in there with that struggle to do what you gotta do...?

Here is the Bradenton Herald –

BRADENTON -- She was 95, had no pulse, was in full cardiac arrest and not breathing. 
But Bradenton Police Department Sgt. John Negron said he saw all-out effort to save Jennie Sanders when he arrived at the residence in the 1200 block of Tidewater Court in Bradenton at 3:48 p.m. Sunday, Jan. 26, including officer Jeremy Telles frantically doing chest compressions. 
"Mrs. Sanders was on the bedroom floor and Jeremy was doing chest compressions while Mrs. Sanders' son-in-law was giving her breaths," Negron said. "Jeremy had been there five minutes before I got there and I yelled, 'Let me swap out.' " He said, 'OK.' Then I did chest compressions."  
After ten minutes, there being no response, the family was asked if there was a DNR order. The family urged the effort to continue.
Emergency medical services workers from the Bradenton Fire Department arrived and injected the patient with fluids, while Negron and Telles kept working in tandem on chest compressions.
Negron said he was
...reminded of his wife, Violette's father, Frederick Schneider, who died in his recliner in Spring Hill in October, leaving Violette no chance to say goodbye.
There was a pulse and Mrs Sanders started breathing. Time is of the essence. You don't think; you act...
"I think because we started so quickly and worked so steadily, there was oxygen still circulating even though we couldn't get a pulse," Negron said.
Mrs. Sanders was taken to the Manatee Memorial Hospital. The frantic determination had produced a result.

Mrs Sanders survived only a day before passing away.

So, what was it all for...? Because that’s what you do and you have to know in your heart of hearts that you have done all that you can do. And every day, even just one day, is a bonus.
"The family was very grateful for the officer's actions because it allowed them the opportunity to properly pay their respects during the interim," Radzilowski said. 
Negron said he was deeply moved by the experience of bringing a person back to life.
"It's satisfying knowing we gave this family an opportunity to say goodbye to their loved one," Negron said. 

Negron and Telles were both named Bradenton PD Officers of the Month for March.

This would not have sat well at all with the Lakhani Recommendations and the EoLC Programmes in the UK.

It is likely that this would not have happened here in the UK. The EoLC Strategy has done its work and done it well in changing attitudes and perceptions. This work continues and is being reinforced with the subtle stratagems of the Dying Matters Coalition.

It is likely that this would not have been possible with such policies set in place of denying hospital re-admissions and downsizing care.

We are only half way there and there is much work to be done. Think what will have been achieved in another five years...!

Changing attitudes and changing perceptions: this is the grand design.

America, this is the face of things to come.

To this family, a day meant everything. Think what four months would mean...

This is Mail Online –
Thousands of men with advanced prostate cancer could be denied a new drug by the NHS rationing body.
Radium-223 extends life by nearly four months and improves quality of life for men whose cancer has spread to the bones.
In the latest blow to men with prostate cancer, the National Institute for Health and Care Excellence (Nice) has issued a draft decision not to recommend its use on the NHS in England and Wales.

More...? You want more?
You wicked, wicked boy. Not four months, not one day more shall you have!  - Apologies to Dickens

In the fictional, resource-stripped world of Soylent Green they have a cost-effective EoLC Strategy set in place. It is at once effective and sympathetic; it is an EoLC and euthanasia programme rolled into one that provides dignity, respect and a grand send-off.

Fittingly Communitarian, no body parts are wasted following death. Soylent Green is people!

Fittingly Communitarian, back in the real world of the one percent, the NCPC and the Dying Matters Coalition, organ donation is incorporated into ACPs.

"Vulnerable older people" are being given the hard sell. ACPs are actually being marketed as "end of life rights".
"With this new information I can now make a fully informed decision on the type of care I want and don’t want at the end of my life and I have the knowledge to take control over my own care, providing me with the peace of mind to know that I have an end of life care plan in place for when the time comes." Jan's Story
As much as we might like it so, it may not be so that we will die as we might like to. The future cannot be safely predicted; it is full of uncertainty. The unknowable and the unforseen frightens those who market death as a positive life option and ACPs as a positive safeguard. They urge us to "talk about it" but, actually, they do not wish to talk about it; they are themselves afraid of death.

It is not possible to determine in advance what specific medical treatments should be necessary or optional or under what circumstances that should be so. ACPs oversimplify the decisions that are being taken, writ in stone, in black and white as legal documents to be complied with for hypothetical future medical scenarios.

There are very real risks that circumstances will arise that would have prompted a different decision had we had prior knowledge and thought it through and that our intention will not accommodate for every possible medical situation and circumstance nor permit manoeuvre for those who must comply with and act upon these 'Last Wishes'.

The unknown and the unknowable are not privy for us to see.

America, these documents are with you and they are called the POLST.

This the Complete Lives System for treatment priority...

This actually matches well with Jacques Attali's outrageous statement -
"As soon as he goes beyond 60-65 years of age man lives beyond his capacity to produce, and he costs society a lot of money...euthanasia will be one of the essential instruments of our future societies."
These documents concern themselves with over-treatment. This befits the Communitarian compartment into which the elderly are dropped. It is clear and apparent that the elderly should not fear the prospect of over-treatment but, rather, the real and ever-present danger of under-treatment.

There is an Hideous Strength at work. It is clear and apparent that the elderly should fear the prospect of an active and enthusiastic euthanasia movement disguising itself and portraying itself as a benefactor of rights.

Medical authorities and courts commonly and frequently intervene to insist upon withdrawal of treatment, including nutrition and hydration.

Rather than a Living Will, it is more appropriate to advance and encourage the will to live.

Further reading -
Liverpool Care Pathway - A Utilitarian Pathway 
Liverpool Care Pathway - Making The MOLST Of Your POLST
Liverpool Care Pathway – An Hideous Strength
Liverpool Care Pathway – The Prophesies of Ezekiel?

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