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| | | INSIDE THE ETHICS COMMITTEE
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Go to the Listen Again page | ![]() | | | | |  | | Wednesdays 29 Aug, 05 & 12 Sep 2007 8.00-8.45pm
Repeated Saturdays 01, 08 & 15 Sep 2007 10.15-11.00pm
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| Wed 29 Aug 2007 (rpt. Sat 01 Sep 2007) |
| | | | | | |  | “I thought the discussion regarding the dilemma of informed consent was most interesting and pertinent to my own field of work. In my experience, I have often thought that the opinion of carers does influence decisions made when trying to decide 'best interests' of patients and I was pleased that the panel picked up on that particular point.”
Dawn
“I assume that the treating clinicians thought it was not in David's best interests to undergo chemotherapy in the light of his lack of understanding and likely reaction to the treatment. If any clinician or carer was of the alternative view that chemotherapy was in his best interests by prolonging his life, the view of the ethics committee should not have been the last word on the matter. This case should then have gone to court for a judicial decision on best interests.”
Laurence
“This was a very well presented debate about complex ethics which couldn't have been done better. The references made to the "capacity act" due to come into force in October were however misleading as parts of the UK already have a well established legal framework for this type of situation. It should have been clarified which parts of the UK the act referred to - this will be especially important next week as eating disorders are specifically mentioned in the Scottish Mental Health Act but not (I think) in the current English one.”
David
“I have never listened to so much clap trap. A normal person could have made the right decision in 5 minutes. It is no wonder this country is in such decline.”
Mike
“In deciding the most ethical strategy for David I wonder how much a person's opinion is coloured by their spiritual outlook. For those who believe that this life is not the end and that a fuller life exists beyond this, it would be easier to conclude that treatment was not in David's best interests than someone who thought that this life is all that there is and that 'aggressive' prolonging of this life is all important. I concluded that owing to David's distress, it was not appropriate to embark on a treatment that had less than 50% certainty of recovery. Having seen at first hand the brilliance of palliative care I believe this was by far the best outcome for David.”
Jenny
“Interesting programme which I made a point of listening to as I'm a speech and language therapist specialising in working with people with learning disabilities. The decision made in this case intrigued me - I wonder how David's dental care was undertaken during his life. This must also have caused him distress and the ensuing mistrust of the staff caring for him.”
Cath
“Excellent programme with a surprising outcome in terms of the votes of the experts. It explored the issues remarkably well given the constraints.”
Nick
“I was surprised at the outcome. I felt that the panel did not give sufficient weight to the man's right to possible life. When discussing what was in his best interests, his right to live was given no more emphasis than his right to avoid upset. My view was that his best interests should have been established objectively, and then the question of whether or not this could be achieved in reasonable circumstances considered. I don't think his situation was no different to that of a 2 year old child, and I don't think anyone would suggest withholding potential life saving treatment because the child would be distressed by the treatment.”
Stephen
“This was an interesting and thought provoking programme. What a difficult choice for the carers and ultimately the doctors to make. I personally felt the right choice was made - David got to keep his dignity and did not fear as he would have done if in hospital. As a student Radiographer, I feel staff in allied health professions need more training in dealing with the type of patient David was, so we can ensure their stay at a hospital would be as comfortable as possible.”
Alison
“I am currently part of a project in Hampshire to train the 70,000+ staff that need to know about the Mental Capacity Act and it is very difficult to get people to understand the Act, its implications and so on. If only I could sit them in a room and play this programme to them! Thank you for tackling such a difficult and somewhat contentious issue, in such a concise, effective way, whilst looking at the questions which we will probably never be able to answer, Best Interest Decisions for example.”
Angharad
“Having listened to last night’s programme, I wanted to say that I was disappointed at the lack of mention by any of your panel of the role of the Independent Mental Capacity Advocate (IMCA) which is now a statutory requirement under the Mental Capacity Act 2005, in cases such as David's where there is no-one close to David who is not paid to be there that the doctors can consult. This part of the Mental Capacity Act came into practice in April of this year and as one of the people providing the service in Oxfordshire, I am only too aware of the LACK of awareness of this role amongst professionals! It is their duty under law to involve an IMCA in these cases and yet that was not made clear by your programme. The IMCA is someone who is independent of everyone and is there to support the decision of what is in the person's best interest, from the person's point of view. I would have thought that all those faced with such difficult decisions as that presented by your programme would welcome such help and therefore it would have been appropriate to highlight the role for those not so clued up on the law. Is there any chance you could make mention of this before the next programme?”
Helen
“I work as a Psychiatric Nurse and a professional Trainer in Health and Social Care. I found this programme really interesting and well presented. The discussions of the concepts contained in the Mental Capacity Act were excellent, although I think it would have been useful to touch upon the 5th principle of the Act - least restrictive practice / proportionality of response - as clearly this is important in any decision about how David should be treated.”
Robert
“As a 16 year-old about to enter the sixth form and preparing to apply to medical school I found it very useful as medical ethics frequently comes up in said medical schools' interviews. Thank you for creating such a programme and I will now be urging all my fellow "wanna-be-doctor" friends to tune in next week!”
Kate
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